Perceived neighborhood built environment and accelerometer-measured physical activity and sedentary behavior among...

Neighborhood built environments may be associated with physical activity and sedentary behavior among older adults. However, evidence from rapidly urbanizing Chinese cities remains limited, particularly studies using objectively measured activity outcomes. This study aimed to examine the associations of perceived neighborhood built environment attributes with accelerometer-measured physical activity and sedentary behavior among older adults in urban China.

Community-based cross-sectional study.

A total of 499 older adults from 32 communities in Nanjing, China, were included. Physical activity and sedentary behavior were measured using ActiGraph GT3X + accelerometers. Perceived neighborhood built environment attributes were assessed using a questionnaire adapted from the Neighborhood Environment Walkability Scale. Multiple linear regression models were used to examine the associations of perceived built environment attributes with total physical activity, light-intensity physical activity, moderate-to-vigorous physical activity, and sedentary behavior, adjusting for sociodemographic and health-related covariates.

Perceived access to service facilities was consistently associated with higher total physical activity, light-intensity physical activity, and moderate-to-vigorous physical activity, and with lower sedentary time. Access to fitness facilities was positively associated with total physical activity and light-intensity physical activity. Better neighborhood aesthetics was associated with higher moderate-to-vigorous physical activity. Traffic site accessibility and street connectivity were associated with lower sedentary time. In contrast, perceived access to commercial facilities was associated with lower total physical activity, light-intensity physical activity, and moderate-to-vigorous physical activity, and with higher sedentary time.

Perceived neighborhood built environment attributes were associated with accelerometer-measured physical activity and sedentary behavior among older adults in urban China. Access to service and fitness facilities, neighborhood aesthetics, public transportation accessibility, and street connectivity may be relevant environmental correlates of active and sedentary lifestyles. The inverse association observed for commercial facility accessibility suggests that the role of destination accessibility may differ in high-density Chinese urban communities. These findings may inform age-friendly community planning and population-level public health strategies aimed at supporting active ageing and reducing sedentary behavior among older adults.