Quality of Urban Green Space for Older Adults to Promote Physical Activity: A Systematic Review

Regular physical activity (PA) is essential for healthy aging. For older adults residing in urban areas, access to urban green space (UGS) can help increase PA levels. This systematic review examined the association between availability, accessibility, and attractiveness of the UGS on PA among older adults. PubMed, CINAHL, and Web of Science were searched for articles published 2016-2024 that used quantitative methods to explore associations between the qualities of UGS and measures of PA in this demographic. Findings from nine studies from Europe, China, Hong Kong, and Australia were synthesized by availability, accessibility, and attractiveness domains. For availability, the presence and size of UGS were positively associated with older adults' PA in several studies, whereas UGS proximity was inconsistently associated with PA. For accessibility, infrastructure-related features such as trail length were positively associated with PA, but findings for park features and safety were mixed. Results were also inconsistent for attractiveness; some land-cover and amenity features showed positive associations, while others showed no clear relationship with PA. In addition to variability in associations, there was great heterogeneity across studies in age inclusion criteria (e.g., 45+ vs. 65+), participant inclusion criteria, setting, operationalization of UGS quality, PA measures, and study rigor, reducing the ability to draw conclusions about the association between UGS qualities and PA. Although findings can begin to inform urban planners, public health professionals, and policymakers in designing UGS to promote PA in older adults, the field would benefit from more consistent definitions and measures of UGS qualities and PA.