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Presence and Visibility of Outdoor and Indoor Physical Activity Features and Participation in Physical Activity Among Older Adults in Retirement Communities

Originally Published:
Key Point Summary
Key Point Summary Author(s):
YoungSeon Choi
Key Concepts/Context

Regular physical activity contributes to better health among old and very old individuals, allowing them to remain independent for a longer period of time. As with other factors, researchers are increasingly examining the role of the physical setting in encouraging or discouraging physical activity and providing convergent evidence on neighborhood design associated with physical activity by older people.


The objective of this study is to examine how the presence and visibility of outdoor and indoor physical activity resources (e.g., walking path/trail, outdoor tennis courts, gardens, etc.) influence participation in physical activity among elderly residents in non-profit continuing care retirement communities (CCRCs) and other senior housing communities. 


The study presented here is part of a larger project that seeks to identify programs, practices, and physical environmental features that promote physical activity in CCRCs and other senior housing with services settings. Data collection occurred for eight weeks starting in January 2004. Surveys were sent via U.S. mail to prime contacts identified in the American Association of Homes and Services for the Aging (AAHSA) membership database. A total of 463 surveys were returned (of the 800 in the random sample). In total, we had 398 valid respondents, for an overall response rate of 52% (398/759).

Design Implications
The presence of certain features such as walking paths, gardens, or outdoor lawn areas and the visibility of courtyards on campus appears to be related to participation in physical activity (e.g., walking clubs). Therefore, architects and designers are encouraged to consider incorporating such features in the design of CCRCs. 

The presence of individual facilities and features as well as the actual number of facilities present appear to be related to resident participation in physical activity. Specifically, campuses with certain outdoor features had more residents participating in different types of activities. For example, campuses with walking paths, gardens, or outdoor lawn areas had more independent living residents participating in walking clubs. Significant relationship was also found between the visibility of courtyards on campus and participation in walking clubs. This suggests that on campuses where natural outdoor features are present on site and visible, more people may participate in a social physical activity such as a walking club. Campuses with more outdoor features are likely to have more residents participating in a range of different activities. A similar trend was seen with the presence and number of indoor physical activity facilities on campus and the participation in physical activities.


Author-identified limitations are as follows: While the AAHSA members of the team pre-tested the questionnaire for comprehension and relevance, this study depends on reports of community managers and other staff, which might not be accurate. Campus staff and management do not have a complete picture of the full range of activities in which residents participate. In addition, the study does not include the perspective of residents. The response rate is quite high for studies of this type, but still remains only slightly over 50%, and the nature of AAHSA's database did not allow us to compare the characteristics of responders and non-responders. The physical activity outcome measure of at least 30 minutes a day CN at least three times per week is a high criterion to set for this population. With this measure the authors of the study do not capture physical activity levels of less frequency or duration. The list of specific physical activities used as outcome measures tends to focus more on programmed, organized physical activities. The list also excludes numerous other types of physical activities that older adults may participate in on a weekly basis (e.g., bicycling, gardening, etc.) that may be done alone or as part of a group.

Design Category
Building location/site optimization
Outcome Category
Patient / resident health outcomes
Environmental Condition Category
Key Point Summary Author(s):
YoungSeon Choi
Primary Author
Joseph, A.