Neighborhood Walkability Associated with Cardiometabolic Risk Factors among Japanese Older Adults:

Differences across physical activity status and fracture history

Abstract

Cardiovascular diseases (CVDs) significantly contribute to global mortality, and few studies have explored the relationship between walkability and cardiometabolic risk factors (CMRFs) especially in Japan. Previous research often focused on gender differences without considering gender, physical activity (PA) status, and fracture history simultaneously. Given Japan’s aging population and the unique impact of the built environment on older adults, it is crucial to examine the relationship between neighborhood walkability and CMRFs in this demographic. In this study, we aimed to clarify the association between neighborhood walkability and four cardiometabolic risk factors (CMRFs) among Japanese older adults and to see if these associations differ by gender, physical activity (PA) status, and fracture history. We used data from 39,577 older adults in Kumamoto Prefecture, Japan, from 2021, to measure residential neighborhood walkability. We analyzed the associations between the walkability index and the four CMRFs (obesity, type-2 diabetes mellitus, dyslipidemia, and hypertension) using SPSS. The results revealed significant associations between walkability and the CMRFs among Japanese older adults. Furthermore, the association varied not only across gender, PA status, and fracture history but also among different CMRFs. This study found the strongest association between walkability and hypertension. The associations between walkability and the CMRFs were observed primarily in physically inactive men, physically active women, and non-fractured women. Moreover, unexpected findings revealed a significant association between higher walkability and increased risks of obesity and type-2 diabetes mellitus in physically inactive men, as well as dyslipidemia in physically inactive men, fractured men, and non-fractured men. These findings highlight the complex effects of walkable environments on the cardiometabolic health of Japanese older adults. This study emphasizes the importance of promoting PA and preventing falls and fractures to reduce the risk of CVDs among older adults.