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Walk the Talk: Characterizing Mobility in Older Adults Living on Low Income

Published online by Cambridge University Press:  03 April 2017

Anna M. Chudyk*
Affiliation:
Centre for Hip Health and Mobility and Department of Medicine, University of British Columbia
Joanie Sims-Gould
Affiliation:
Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia
Maureen C. Ashe
Affiliation:
Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia
Meghan Winters
Affiliation:
Faculty of Health Sciences, Simon Fraser University
Heather A. McKay
Affiliation:
Centre for Hip Health and Mobility and Department of Family Practice, University of British Columbia
*
La correspondance et les demandes de tire-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Anna M. Chudyk, Ph.D. Centre for Hip Health and Mobility and Department of Medicine University of British Columbia 2635 Laurel Street Vancouver, BC, V5Z 1M9 <anna.chudyk@hiphealth.ca>

Abstract

We provide an in-depth description of the mobility (capacity and enacted function, i.e., physical activity and travel behaviour) of community-dwelling older adults of low socioeconomic status. Participants [n = 161, mean age (range) = 74 (65-96) years] completed interviewer-administered questionnaires and objective measures of mobility. Our findings did not generally indicate that older adults of low socioeconomic status have a reduced capacity to be mobile. Participants presented with positive profiles across physical, psychosocial, and social environment domains that influence the capacity to be mobile. They also made a high proportion of trips by foot, although these did not together serve to meet physical activity guidelines for most. We challenge future researchers to focus on innovative strategies to recruit this difficult-to-access population, to consider the influence of socioeconomic status across the lifespan, and the role of behaviour-driven agency when investigating the association between the person, environment, and older adult mobility.

Résumé

Nous offrons une description en profondeur de la mobilité des personnes âgées (activité physique et comportement de voyage) de faible statut socioéconomique vivant dans les communautés. Les participants (n = 161, âge moyen [intervalle] = 74 [65-96] ans) ont rempli des questionnaires administrés par les enquêteurs et ont participé à des mesures objectives de la mobilité. En général, nos résultats n’ont pas indiqué que les personnes âgées de faible statut socio-économique ont une capacité réduite d’être mobiles. Les participants, malgré un désavantage économique, ont présenté des profils positifs, physiques, psychosociaux et liés à leur environnement social, qui influencent tous la capacité d’être mobiles. Ils ont également entrepris une grande proportion des déplacements à pied, bien que ceux-ci ne l’ont pas, pris ensemble, répondu aux directives physiques pour la plupart d’entre eux. Nous incitons les futurs chercheurs à mettre l’accent sur des stratégies novatrices de recrutement de cette population, difficilement accessible, afin de prendre en compte l’influence du statut socio-économique sur la durée de vie, ainsi que le rôle des facteurs liés au comportement lors de l’étude des relations entre une personne, son environnement et la mobilité des aînés.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2017 

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Footnotes

*

The Walk the Talk team would like to acknowledge the important contributions of its key community partners: BC Housing, the City of Vancouver, and the BC Ministry of Health. This study would not be possible without the commitment of the older adults who participated – we are most grateful. We are also most grateful to the Canadian Institutes of Health Research (CIHR; Mobility and Aging Team Grant Competition) for their support of the Walk the Talk: Transforming the Built Environment to Enhance Mobility in Seniors Team (CIHR grant # 108607). Anna Chudyk is supported by a Vanier Canada Graduate Scholarship from the CIHR. Maureen Ashe and Joanie Sims-Gould are supported by career awards from the CIHR and the Michael Smith Foundation for Health Research.

References

Altman, D. G., & Bland, J. M. (1994). Quartiles, quintiles, centiles, and other quantiles. BMJ, 309(6960), 996.Google Scholar
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Annear, M., Keeling, S., Wilkinson, T., Cushman, G., Gidlow, B., & Hopkins, H. (2014). Environmental influences on healthy and active ageing: A systematic review. Ageing & Society, 34(4), 590622. doi: 10.1017/S0144686x1200116x CrossRefGoogle Scholar
Asher, L., Aresu, M., Falaschetti, E., & Mindell, J. (2012). Most older pedestrians are unable to cross the road in time: A cross-sectional study. Age and Ageing, 41(5), 690694.Google Scholar
Asano, M., Miller, W. C., & Eng, J. J. (2007). Development and psychometric properties of the ambulatory self-confidence questionnaire. Gerontology, 53(6), 373381. doi: 10.1159/000104830 Google Scholar
BC Housing. (n.d.). About BC Housing. Retrieved from http://www.bchousing.org/aboutus Google Scholar
Blondell, S. J., Hammersley-Mather, R., & Veerman, J. L. (2014). Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies. BMC Public Health, 14, 510–510. doi: 10.1186/1471-2458-14-510 Google Scholar
Brownson, R. C., Chang, J. J., Eyler, A. A., Ainsworth, B. E., Kirtland, K. A., Saelens, B. E., & Sallis, J. F. (2004). Measuring the environment for friendliness toward physical activity: A comparison of the reliability of 3 questionnaires. American Journal of Public Health, 94(3), 473483.CrossRefGoogle ScholarPubMed
Buchman, A. S., Boyle, P. A., Wilson, R. S., James, B. D., Leurgans, S. E., Arnold, S. E., & Bennett, D. A. (2010). Loneliness and the rate of motor decline in old age: The rush memory and aging project, a community-based cohort study. BMC Geriatrics, 10. doi: 10.1186/1471-2318-10-77 Google Scholar
Canadian Institutes of Health Research. (2014). Mobility in aging – A strategic initiative of the CIHR Institute of Aging. Retrieved from http://www.cihr.ca/e/29994.html.Google Scholar
Cao, X. Y., Mokhtarian, P. L., & Handy, S. L. (2010). Neighborhood design and the accessibility of the elderly: An empirical analysis in Northern California. International Journal of Sustainable Transportation, 4(6), 347371. doi: 10.1080/15568310903145212 Google Scholar
Centers for Disease Control and Prevention. (n.d.). The state of aging and health in America 2013. Retrieved from http://www.cdc.gov/features/agingandhealth/state_of_aging_and_health_in_america_2013.pdf.Google Scholar
Cerin, E., Conway, T. L., Saelens, B. E., Frank, L. D., & Sallis, J. F. (2009). Cross-validation of the factorial structure of the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A). The International Journal of Behavioral Nutrition and Physical Activity, 6, 32. doi: 10.1186/1479-5868-6-32 Google Scholar
Cerin, E., Saelens, B. E., Sallis, J. F., & Frank, L. D. (2006). Neighborhood environment walkability scale: validity and development of a short form. Medicine and Science in Sports and Exercise, 38(9), 16821691. doi: 10.1249/01.mss.0000227639.83607.4d Google Scholar
Chudyk, A. M., Winters, M., Moniruzzaman, M., Ashe, M. C., Sims-Gould, J., & McKay, H. A. (2015). Destinations matter: The association between where older adults live and their travel behavior. Journal of Transport & Health, 2(1), 5057. doi: 10.1016/j.jth.2014.09.008 CrossRefGoogle ScholarPubMed
Clarke, P., Ailshire, J. A., Nieuwenhuijsen, E. R., & de Kleijn-de Vrankrijker, M. W. (2011). Participation among adults with disability: the role of the urban environment. Social Science & Medicine, 72(10), 16741684. doi: 10.1016/j.socscimed.2011.03.025 Google Scholar
Cohen, S. (1988). Perceived stress in a probability sample of the United States. In Oskamp, S. S. S. (Ed.), The social psychology of health (pp. 3167). Thousand Oaks, CA: Sage.Google Scholar
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385396.Google Scholar
Colbert, L. H., Matthews, C. E., Havighurst, T. C., Kim, K., & Schoeller, D. A. (2011). Comparative validity of physical activity measures in older adults. Medicine and Science in Sports and Exercise, 43(5), 867876. doi: 10.1249/MSS.0b013e3181fc7162 Google Scholar
Colley, R. C., Garriguet, D., Janssen, I., Craig, C. L., Clarke, J., & Tremblay, M. S. (2011). Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Reports, 22(1), 714.Google ScholarPubMed
Cradock, A. L., Kawachi, I., Colditz, G. A., Gortmaker, S. L., & Buka, S. L. (2009). Neighborhood social cohesion and youth participation in physical activity in Chicago. Social Science & Medicine, 68(3), 427435. doi: 10.1016/j.socscimed.2008.10.028 CrossRefGoogle ScholarPubMed
Davis, M. G., Fox, K. R., Hillsdon, M., Sharp, D. J., Coulson, J. C., & Thompson, J. L. (2011). Objectively measured physical activity in a diverse sample of older urban UK adults. Medicine and Science in Sports and Exercise, 43(4), 647654. doi: 10.1249/MSS.0b013e3181f36196 Google Scholar
Dong, Y. H., Lee, W. Y., Basri, N. A., Collinson, S. L., Merchant, R. A., Venketasubramanian, N., & Chen, C. L. (2012). The Montreal Cognitive Assessment is superior to the Mini-Mental State Examination in detecting patients at higher risk of dementia. International Psychogeriatrics, 24(11), 17491755. doi: 10.1017/S1041610212001068 CrossRefGoogle Scholar
Ezzati, A., Jiang, J., Katz, M. J., Sliwinski, M. J., Zimmerman, M. E., & Lipton, R. B. (2014). Validation of the Perceived Stress Scale in a community sample of older adults. International Journal of Geriatric Psychiatry, 29(6), 645652. doi: 10.1002/gps.4049 Google Scholar
Fan, E., Gifford, J. M., Chandolu, S., Colantuoni, E., Pronovost, P. J., & Needham, D. M. (2012). The functional comorbidity index had high inter-rater reliability in patients with acute lung injury. BMC Anesthesiology, 12, 21. doi: 10.1186/1471-2253-12-21 Google Scholar
Fortin, M., Hudon, C., Dubois, M. F., Almirall, J., Lapointe, L., & Soubhi, H. (2005). Comparative assessment of three different indices of multimorbidity for studies on health-related quality of life. Health and Quality of Life Outcomes, 3, 74. doi: 10.1186/1477-7525-3-74 CrossRefGoogle ScholarPubMed
Frank, L. D. (2013). Enhancing Walk Score’s ability to predict physical activity and active transportation. Retrieved from http://activelivingresearch.org/files/2013_Bike-WalkScore_Frank.pdf Google Scholar
Frank, L. D., Kerr, J., Rosenberg, D., & King, A. C. (2010). Healthy aging and where you live: Community design relationships with physical activity and body weight in older Americans. Journal of Physical Activity & Health, 7(S1), S8290.CrossRefGoogle ScholarPubMed
Franke, T., Tong, C., Ashe, M. C., McKay, H. A., Sims-Gould, J., & The Walk the Talk Team. (2013). The secrets of highly active older adults. Journal of Aging Studies, 27(4), 398409. doi: 10.1016/j.jaging.2013.09.003 CrossRefGoogle ScholarPubMed
Freedson, P. S., Melanson, E., & Sirard, J. (1998). Calibration of the Computer Science and Applications, Inc. accelerometer. Medicine and Science in Sports and Exercise, 30(5), 777781.Google Scholar
Freire, A. N., Guerra, R. O., Alvarado, B., Guralnik, J. M., & Zunzunegui, M. V. (2012). Validity and reliability of the short physical performance battery in two diverse older adult populations in Quebec and Brazil. Journal of Aging and Health, 24(5), 863878. doi: 10.1177/0898264312438551 CrossRefGoogle ScholarPubMed
Freitas, S., Simoes, M. R., Alves, L., & Santana, I. (2011). Montreal Cognitive Assessment (MoCA): Normative study for the Portuguese population. Journal of Clinical and Experimental Neuropsychology, 33(9), 989996. doi: 10.1080/13803395.2011.589374 Google Scholar
Fritz, S., & Lusardi, M. (2009). White paper: “Walking speed: The sixth vital sign”. Journal of Geriatric Physical Therapy, 32(2), 4649.Google Scholar
Fujiwara, Y., Suzuki, H., Kawai, H., Hirano, H., Yoshida, H., Kojima, M., … Obuchi, S. (2013). Physical and sociopsychological characteristics of older community residents with mild cognitive impairment as assessed by the Japanese version of the Montreal Cognitive Assessment. Journal of Geriatric Psychiatry and Neurology, 26(4), 209220. doi: 10.1177/0891988713497096 CrossRefGoogle ScholarPubMed
Groll, D. L., To, T., Bombardier, C., & Wright, J. G. (2005). The development of a comorbidity index with physical function as the outcome. Journal of Clinical Epidemiology, 58(6), 595602. doi: 10.1016/j.jclinepi.2004.10.018 CrossRefGoogle ScholarPubMed
Grundy, E., & Holt, G. (2001). The socioeconomic status of older adults: How should we measure it in studies of health inequalities? Journal of Epidemiology and Community Health, 55(12), 895904. doi: 10.1136/jech.55.12.895 Google Scholar
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556561.Google Scholar
Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., … Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), M8594.Google Scholar
Handy, S. L., Boarnet, M. G., Ewing, R., & Killingsworth, R. E. (2002). How the built environment affects physical activity–Views from urban planning. American Journal of Preventive Medicine, 23(2), 6473. doi: 10.1016/S0749-3797(02)00475-0 Google Scholar
Hanson, H. M., Ashe, M. C., McKay, H. A., & Winters, M. (2012). Intersection between the built and social environments and older adult’s mobility: An evidence review. Retrieved from www.ncceh.ca/sites/default/files/Built_and_Social_Environments_Older_Adults_Nov_2012.pdf Google Scholar
Harada, N. D., Chiu, V., King, A. C., & Stewart, A. L. (2001). An evaluation of three self-report physical activity instruments for older adults. Medicine and Science in Sports and Exercise, 33(6), 962970.Google Scholar
Hawkley, L. C., Browne, M. W., & Cacioppo, J. T. (2005). How can I connect with Thee?: Let me count the ways. Psychological Science, 16(10), 798804. doi: 10.1111/j.1467-9280.2005.01617.x Google Scholar
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., … Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 17271736. doi: 10.1007/s11136-011-9903-x Google Scholar
Herrmann, S. D., Barreira, T. V., Kang, M., & Ainsworth, B. E. (2013). How many hours are enough? Accelerometer wear time may provide bias in daily activity estimates. Journal of Physical Activity & Health, 10(5), 742749.Google Scholar
House, J. S. (1994). Americans’ Changing Lives: Waves I and II, 1986 and 1989 [Computer file]. ICPSR version. Ann Arbor, MI: University of Michigan, Survey Research Center.Google Scholar
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655672. doi: 10.1177/0164027504268574 CrossRefGoogle Scholar
Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2003). Socioeconomic inequalities in morbidity among the elderly; A European overview. Social Science & Medicine, 57(5), 861873. doi: 10.1016/S0277-9536(02)00454-9 Google Scholar
Human Resources and Skills Development Canada. (2011). 2011 Federal Disability Report: Seniors with disabilities in Canada. Retrieved from www.esdc.gc.ca/eng/disability/arc/federal_report2011/pdf/fdr_2011.pdf Google Scholar
Institute of Medicine (US) Committee on Health and Behavior: Research, Practice, and Policy. (2001). 4. Social risk factors. In Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington, DC: National Academies Press.Google Scholar
Johnson, J. A., & Pickard, A. S. (2000). Comparison of the EQ-5D and SF-12 Health Surveys in a General Population Survey in Alberta, Canada. Medical Care, 38(1), 115121.Google Scholar
King, A. C., Sallis, J. F., Frank, L. D., Saelens, B. E., Cain, K. L., Conway, T. L., … Kerr, J. (2011). Aging in neighborhoods differing in walkability and income: Associations with physical activity and obesity in older adults. Social Science & Medicine, 73(10), 15251533. doi: 10.1016/j.socscimed.2011.08.032 CrossRefGoogle ScholarPubMed
Koster, A., Bosma, H., Kempen, G. I. J. M., Penninx, B. W. J. H., Beekman, A. T. F., Deeg, D. J. H., … van Eijk, J. Th. M. (2006a). Socioeconomic differences in incident depression in older adults: The role of psychosocial factors, physical health status, and behavioral factors. Journal of Psychosomatic Research, 61(5), 619627. doi: 10.1016/j.jpsychores.2006.05.009 Google Scholar
Koster, A., Bosma, H., van Groenou, M. I. B., Kempen, G. I. J. M., Penninx, B. W. J. H., van Eijk, J. T. H. N., & Deeg, D. J. H. (2006b). Explanations of socioeconomic differences in changes in physical function in older adults: Results from the Longitudinal Aging Study Amsterdam. BMC Public Health, 6. doi: 10.1186/1471-2458-6-244 Google Scholar
Koster, A., Penninx, B. W. J. H., Bosma, H., Kempen, G. I. J. M., Harris, T. B., Newman, A. B., … Kritchevsky, S. B. (2005). Is there a biomedical explanation for socioeconomic differences in incident mobility limitation? The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(8), 10221027.Google Scholar
Lawton, M. P. (1989). Environment proactivity and affect in older people. In Spacapan, S. & Oskamp, S. (Eds.), The social psychology of aging (pp. 135164). Newbury Park, CA: Sage.Google Scholar
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In Eisdorfer, C., & Lawton, M. P. (Eds.), The psychology of adult development and aging (pp. 619674). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Lee, E. H. (2012). Review of the psychometric evidence of the perceived stress scale. Asian Nursing Research, 6(4), 121127. doi: 10.1016/j.anr.2012.08.004 Google Scholar
Lin, J. S., O’Connor, E., Rossom, R. C., Perdue, L. A., & Eckstrom, E. (2013). Screening for cognitive impairment in older adults: A systematic review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 159(9), 601612. doi: 10.7326/0003-4819-159-9-201311050-00730 Google Scholar
Lochner, K. A., Kawachi, I., Brennan, R. T., & Buka, S. L. (2003). Social capital and neighborhood mortality rates in Chicago. Social Science & Medicine, 56(8), 17971805. doi: 10.1016/S0277-9536(02)00177-6 Google Scholar
Mair, C., Roux, A. V. D., & Morenoff, J. D. (2010). Neighborhood stressors and social support as predictors of depressive symptoms in the Chicago Community Adult Health Study. Health & Place, 16(5), 811819. doi: 10.1016/j.healthplace.2010.04.006 Google Scholar
Marmot, M. G., Smith, G. D., Stansfeld, S., Patel, C., North, F., Head, J., … Feeney, A. (1991). Health inequalities among British civil servants–The Whitehall II study. Lancet, 337(8754), 13871393.Google Scholar
Martinson, B. C., Crain, A. L., Sherwood, N. E., Hayes, M. G., Pronk, N. P., & O’Connor, P. J. (2010). Population reach and recruitment bias in a maintenance RCT in physically active older adults. Journal of Physical Activity & Health, 7(1), 127135.CrossRefGoogle Scholar
Matthews, C. E., Chen, K. Y., Freedson, P. S., Buchowski, M. S., Beech, B. M., Pate, R. R., & Troiano, R. P. (2008). Amount of time spent in sedentary behaviors in the United States, 2003–2004. American Journal of Epidemiology, 167(7), 875881. doi: 10.1093/aje/kwm390 Google Scholar
Matthews, K. A., Gallo, L. C., & Taylor, S. E. (2010). Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future. Annals of the New York Academy of Sciences, 1186, 146173. doi: 10.1111/j.1749-6632.2009.05332.x Google Scholar
McNeill, L. H., Kreuter, M. W., & Subramanian, S. V. (2006). Social environment and physical activity: A review of concepts and evidence. Social Science & Medicine, 63(4), 10111022. doi: 10.1016/j.socscimed.2006.03.012 CrossRefGoogle ScholarPubMed
McPherson, B. D., & Wister, A. V. (2008). Aging as a social process: Canadian perspectives (5th ed.). Don Mills, ON: Oxford University Press.Google Scholar
Montufar, J., Arango, J., Porter, M. M., & Nakagawa, S. (2007). Pedestrians’ normal walking speed and speed when crossing a street. Transportation Research Record, 2002(1), 9097. doi: 10.3141/2002-12 CrossRefGoogle Scholar
Musick, M. A., Herzog, A. R., & House, J. S. (1999). Volunteering and mortality among older adults: Findings from a national sample. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54(3), S173S180.CrossRefGoogle ScholarPubMed
Mustard, C. A., Derksen, S., Berthelot, J. M., Wolfson, M., & Roos, L. L. (1997). Age-specific education and income gradients in morbidity and mortality in a Canadian province. Social Science & Medicine, 45(3), 383397. doi: 0.1016/S0277-9536(96)00354-1 Google Scholar
Narazaki, K., Nofuji, Y., Honda, T., Matsuo, E., Yonemoto, K., & Kumagai, S. (2013). Normative data for the Montreal Cognitive Assessment in a Japanese community-dwelling older population. Neuroepidemiology, 40(1), 2329. doi: 10.1159/000339753 Google Scholar
Nasreddine, Z. S., Phillips, N. A., Bedirian, V., Charbonneau, S., Whitehead, V., Collin, I., … Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695699. doi: 10.1111/j.1532-5415.2005.53221.x CrossRefGoogle Scholar
Nilsson, C. J., Avlund, K., & Lund, R. (2010). Social inequality in onset of mobility disability among older Danes: The mediation effect of social relations. Journal of Aging and Health, 22(4), 522541. doi: 10.1177/0898264309359684 Google Scholar
Noreau, L., & Boschen, K. (2010). Intersection of participation and environmental factors: A complex interactive process. Archives of Physical Medicine and Rehabilitation, 91(Suppl. 9), S4453. doi: 10.1016/j.apmr.2009.10.037 Google Scholar
Ostir, G. V., Volpato, S., Fried, L. P., Chaves, P., & Guralnik, J. M. (2002). Reliability and sensitivity to change assessed for a summary measure of lower body function: Results from the Women’s Health and Aging Study. Journal of Clinical Epidemiology, 55(9), 916921. doi: http://dx.doi.org/10.1016/S0895-4356(02)00436-5 Google Scholar
Ovrum, A., Gustavsen, G. W., & Rickertsen, K. (2014). Age and socioeconomic inequalities in health: Examining the role of lifestyle choices. Advances in Life Course Research, 19, 113. doi: 10.1016/j.alcr.2013.10.002 Google Scholar
Perissinotto, C. M., Stijacic Cenzer, I., & Covinsky, K. E. (2012). Loneliness in older persons: A predictor of functional decline and death. Archives of Internal Medicine, 172(14), 10781083. doi: 10.1001/archinternmed.2012.1993 Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256(3), 183194. doi: 10.1111/j.1365-2796.2004.01388.x Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56(3), 303308.Google Scholar
Rantakokko, M., Iwarsson, S., Vahaluoto, S., Portegijs, E., Viljanen, A., & Rantanen, T. (2014). Perceived environmental barriers to outdoor mobility and feelings of loneliness among community-dwelling older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. doi: 10.1093/gerona/glu069 CrossRefGoogle ScholarPubMed
Raudenbush, S. W., & Sampson, R. J. (1999). Ecometrics: Toward a science of assessing ecological settings, with application to the systematic social observation of neighborhoods. Sociological Methodology, 29, 141. doi: 10.1111/0081-1750.00059 Google Scholar
Reid, D. D., Hamilton, P. J., Keen, H., Brett, G. Z., Jarrett, R. J., & Rose, G. (1974). Cardiorespiratory disease and diabetes among middle-aged male civil servants – Study of screening and intervention. Lancet, 1(7856), 469473.Google Scholar
Rossetti, H. C., Lacritz, L. H., Cullum, C. M., & Weiner, M. F. (2011). Normative data for the Montreal Cognitive Assessment (MoCA) in a population-based sample. Neurology, 77(13), 12721275. doi: 10.1212/WNL.0b013e318230208a Google Scholar
Rosso, A. L., Grubesic, T. H., Auchincloss, A. H., Tabb, L. P., & Michael, Y. L. (2013). Neighborhood amenities and mobility in older adults. American Journal of Epidemiology, 178(5), 761769. doi: 10.1093/aje/kwt032 Google Scholar
Rueggeberg, R., Wrosch, C., & Miller, G. E. (2012). The different roles of perceived stress in the association between older adults’ physical activity and physical health. Health Psychology, 31(2), 164171. doi: 10.1037/a0025242 Google Scholar
Russell, D. W. (1996). UCLA loneliness scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66(1), 2040. doi: 10.1207/s15327752jpa6601_2 Google Scholar
Sampson, R. J. (2012). Great American City: Chicago and the enduring neighbourhood effect (pp. 121148). Chicago, Il: The University of Chicago Press.CrossRefGoogle Scholar
Sampson, R. J., & Raudenbush, S. W. (1999). Systematic social observation of public spaces: A new look at disorder in urban neighborhoods. American Journal of Sociology, 105(3), 603651. doi: 10.1086/210356 Google Scholar
Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997). Neighborhoods and violent crime: a multilevel study of collective efficacy. Science, 277(5328), 918924.Google Scholar
Satariano, W. A., Guralnik, J. M., Jackson, R. J., Marottoli, R. A., Phelan, E. A., & Prohaska, T. R. (2012). Mobility and aging: New directions for public health action. American Journal of Public Health, 102(8), 15081515. doi: 10.2105/AJPH.2011.300631 Google Scholar
Schnirer, L., & Stack-Cutler, H. (2012). Recruitment and engagement of low-income populations: Service provider and research perspectives. Edmonton, AB: Community-University Partnership for the Study of Children, Youth, and Families.Google Scholar
Shumway-Cook, A., Ciol, M. A., Yorkston, K. M., Hoffman, J. M., & Chan, L. (2005). Mobility limitations in the Medicare population: Prevalence and sociodemographic and clinical correlates. Journal of the American Geriatrics Society, 53(7), 12171221. doi: 10.1111/j.1532-5415.2005.53372.x Google Scholar
Shumway-Cook, A., Patla, A., Stewart, A. L., Ferrucci, L., Ciol, M. A., & Guralnik, J. M. (2003). Environmental components of mobility disability in community-living older persons. Journal of the American Geriatrics Society, 51(3), 393398.Google Scholar
Singh-Manoux, A. (2003). Psychosocial factors and public health. Journal of Epidemiology and Community Health, 57(8), 553554. doi: 10.1136/jech.57.8.553 Google Scholar
Smith, J., Fisher, G., Ryan, L., Clarke, P., House, J. S., & Weir, D. (2013). Psychosocial and lifestyle questionnaire 2006-2010: Documentation report. Core Section LB. Ann Arbor, MI: University of Michigan.Google Scholar
Spirduso, W. W., Francis, K. L., & MacRae, P. G. (2005). Physical dimensions of aging (2nd ed.). Windsor, ON: Human Kinetics.Google Scholar
Statistics Canada. (2008). Table 13 Prevalence of mobility-related disability among adults aged 65 years and over, by age groups and sex, Canada, 2006 . Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/pub/89-628-x/2007002/t/4183073-eng.htm Google Scholar
Statistics Canada. (2009). Population 15 years and over by highest certificate, diploma or degree, by age groups (2006 Census) . Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/educ43b-eng.htm Google Scholar
Statistics Canada. (2012). Vancouver, British Columbia (Code 933) and British Columbia (Code 59) (table). Census Profile. 2011 Census. Ottawa, ON: Author. Retrieved from http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E Google Scholar
Statistics Canada. (2013). CANSIM Table 202-0603- Average income after tax by economic family types (2007 to 2011) . Ottawa, ON: Author. Retrieved from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/famil21a-eng.htm Google Scholar
Stewart, A. L., Mills, K. M., King, A. C., Haskell, W. L., Gillis, D., & Ritter, P. L. (2001). CHAMPS physical activity questionnaire for older adults: Outcomes for interventions. Medicine and Science in Sports and Exercise, 33(7), 11261141.Google Scholar
Sun, F., Norman, I. J., & While, A. E. (2013). Physical activity in older people: A systematic review. BMC Public Health, 13, 449. doi: 10.1186/1471-2458-13-449 Google Scholar
Taylor, S. E., & Seeman, T. E. (1999). Psychosocial resources and the SES-health relationship. Annals of the New York Academy of Sciences, 896, 210225.Google Scholar
The Conference Board of Canada. (2013). Elderly poverty. Retrieved from http://www.conferenceboard.ca/hcp/details/society/elderly-poverty. Ottawa, ON: Author.Google Scholar
Mustel Group. (2010). TransLink’s 2008 regional trip diary survey: Final report. Retrieved from http://starcanada.ca/star-training-materials-and-resources/reports-seniors-transportation/ Google Scholar
Tremblay, M. S., Warburton, D. E., Janssen, I., Paterson, D. H., Latimer, A. E., Rhodes, R. E., … Duggan, M. (2011). New Canadian physical activity guidelines. Applied Physiology, Nutrition, and Metabolism, 36(1), 3646. doi: 10.1139/H11-009 CrossRefGoogle ScholarPubMed
Turcotte, M. (2012). Profile of seniors’ transportation habits. Canadian Social Trends, 93, 116.Google Scholar
Veroff, J., Kulka, R. A., & Douvan, E. (1981). Mental health in America: Patterns of help-seeking from 1957 to 1976. New York, NY: Basic Books.Google Scholar
Wahl, H. W., Iwarsson, S., & Oswald, F. (2012). Aging Well and the Environment: Toward an Integrative Model and Research Agenda for the Future. The Gerontologist. doi: 10.1093/geront/gnr154 CrossRefGoogle ScholarPubMed
Webber, S. C., Porter, M. M., & Menec, V. H. (2010). Mobility in older adults: A comprehensive framework. Gerontologist, 50(4), 443450. doi: 10.1093/geront/gnq013 Google Scholar
Winters, M., Voss, C., Ashe, M. C., Gutteridge, K., McKay, H. A., & Sims-Gould, J. (2015). Where do they go and how do they get there? Older adults’ travel behaviour in a highly walkable environment. Social Science & Medicine, 133, 304312. doi: 10.1016/j.socscimed.2014.07.006 Google Scholar
Wister, A. V., Levasseur, M., Griffith, L. E., & Fyffe, I. (2015). Estimating multiple morbidity disease burden among older persons: A convergent construct validity study to discriminate among six chronic illness measures, CCHS 2008/09. BMC Geriatrics, 15, 12.Google Scholar