Effects of environmental and social facilitators on physical activity among older adults: A population-based study in...

Regular physical activity is essential for healthy aging, but adherence among older adults remains low. Few studies have examined the influence of environmental and social factors on activity.

To analyze the associations between facilitators ‒ built environment, safety, social support, and public programs ‒ and physical activity among older adults.

Data from 1,017 individuals aged 60-years or older from the 2015 São Paulo Health Survey were analyzed. Physical activity (≥150 min/week) was assessed using the IPAQ. Poisson regression estimated associations with individual facilitators and a cumulative score.

Overall, 30.1% achieved ≥150 min/week of physical activity. Awareness of public programs was associated with a higher likelihood of physical activity (PR = 1.63; 95% CI 1.28-2.09). Older adults living in the Southeast (PR = 1.55; 95% CI 1.09-2.20) and East zones (PR = 1.54; 95% CI 1.04-2.27) were more likely to achieve ≥150 min/week than those living in the North. Compared with those reporting no facilitators, the likelihood of meeting recommendations increased with the number of facilitators: PR = 1.48 (95% CI 1.00-2.19) for three facilitators, PR = 2.19 (95% CI 1.44-3.32) for four, and PR = 2.39 (95% CI 1.19-4.78) for five facilitators.

Physical activity among older adults was associated with awareness of public programs and area of residence, suggesting territorial differences in opportunities for physical activity across São Paulo. Additionally, a cumulative pattern was observed, suggesting that the combined presence of environmental and social facilitators may further increase engagement in physical activity.