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    • Outdoor recreation including walking jogging and cycling may

    2018-11-05

    Outdoor recreation, including walking, jogging and cycling, may be the best source of physical activity for older people, as it neuraminidase inhibitors can be incorporated in daily life (Ogilvie et al., 2007), has been shown to lead to a decrease in all-cause mortality and chronic disease (Zhao et al., 2015), it facilitates social contact (World Health Organisation, 2002), can result in higher levels of physical activity (Kerr et al., 2012) and may provide additional health benefits over engaging in activity indoors (Thompson Coon et al., 2011). However, maintaining outdoor mobility may be a challenge in later life, as individuals are at increased risk of sensory or physical impairment with age, and may be subject to environmental barriers (Mollenkopf et al., 2004; Yeom, Fleury, & Keller, 2008). Physical activity levels are determined by individual characteristics and shared factors such as the natural and built environment (McCormack & Shiell, 2011). One key aspect of the natural environment is both presence of, and access to, green spaces which may encourage higher levels of physical activity for recreation and transport (Paquet et al., 2013; Van Cauwenberg et al., 2011). Mobility and function in older adults has been associated with proximity to (Rosso, Auchincloss, & Michael, 2011), and quality of greenspace and green infrastructure in the built environment (Tzoulas et al., 2007), such as the presence of recreational facilities and clean environments (Wu, Prina, & Brayne, 2015), spaces that are designed according to the expressed need of individuals (Ward Thompson, 2013; Kerr, Rosenberg, & Frank, 2012), and factors of urban planning and design (Durand, Andalib, Dunton, Wolch, & Pentz, 2011). The relationship between physical activity and greenspace has been shown to be independent of preferences in self-selection of home location (Handy, Cao, & Mokhtarian, 2006). Whilst there is some cross-sectional evidence of a positive association between greenspace, its use for physical activity and health, findings are generally equivocal in the literature. This may in part be due to a lack of prospective studies of physical activity trajectories over time (Lee & Maheswaran, 2011). In addition, few studies have focused on specific domains of physical activity that may be associated with exposure to greenspace (Lachowycz & Jones, 2011). A particular example is recreational walking which makes an important contribution to overall physical activity in older people (Tse, Wong, & Lee, 2015). Finally, the mechanisms and moderators, including personal, social and environmental factors which help to explain the relationship between the environment and physical activity have not been well evaluated (Van Cauwenberg et al., 2011; Annear et al., 2014). For example, dog walkers are more likely to achieve higher levels of physical activity than others (Cutt, Giles-Corti, & Knuiman, 2008), and as dog walking often occurs in greenspace (Richards, McDonough, Edwards, Lyle, & Troped, 2013), it may be one mechanism that explains higher levels of physical activity and sense of community in greener areas (Lachowycz & Jones, 2013; Toohey, McCormack, Doyle-Baker, Adams, & Rock, 2013). This lack of understanding limits our ability to provide greenspace or physical activity interventions that are most supportive of active ageing. This analysis evaluates the role of greenspace in protecting against decline in physical activity over time in older adults, and considers potential mechanisms. It uses the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort study in the UK, which provides data on a wide range of health and lifestyle factors, obtained over a 7.5 year follow-up period in a population-based sample of more than 25,000 adults (Ward Thompson, 2013).
    Materials and methods
    Results
    Discussion
    Conclusions
    Competing interests
    Acknowledgements
    This work was supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from Cancer Research UK, the British Heart Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The corresponding author was supported by the Medical Research Council, grant number MR/K025147/1. The study was also supported by the Medical Research Council, grant numbers MC_UU_12015/1 and MC_UU_12015/4. The views and opinions expressed herein are those of the authors. The funders had no role in study design, data analysis, the decision to publish, or the preparation of the manuscript.