Non-linear Relationships Between the Built Environment and Walking Frequency Among Older Adults in Zhongshan, China.

Aim: Promoting walking activity is an effective way to improve the health of older adults. Walking frequency is a critical component of walking behavior and an essential determinant of daily walking levels. To decipher the association between the built environment and walking frequency among older adults, this study's aims are as follows: (1) to empirically test whether non-linear relationships between the two exist, and (2) to identify the thresholds of the built environment characteristics that promote walking.

Methods

The walking frequency of old adults was derived from the Zhongshan Household Travel Survey (ZHTS) in 2012. The sample size of old adults aged 60 or over was 4784 from 274 urban and rural neighborhoods. A semi-parametric generalized additive model (GAMM) is used to analyze the non-linear or non-monotonic relationships between the built environment and the walking frequency among older adults.

Results

We found that non-linear relationships exist among five out of the six built environment characteristics. Within certain thresholds, the population density, sidewalk density, bus stop density, land use mixture, and the percentage of green space are positively related to older adults' walking trips. Furthermore, the land use mixture and the percentage of green space show an inverse "V"-shaped relationship.

Conclusions

Built environment features can either support or hinder the walking frequency among older adults. The findings in the current study contribute to effective land use and transport policies for promoting active travel among older adults.