Neighborhood environment and body mass index in community-dwelling older adults in China: The mediating role of transport-related physical activity

OBJECTIVES: To examine whether the associations of neighborhood environment and body mass index (BMI) of community-dwelling older adults aged 70 and above were mediated by transport-related physical activity (TRPA). METHODS: A bootstrap method was employed to test the mediation model with multisource data from Chongqing, China. RESULTS: Neighborhood walkability (effect: 0.030, 95% CI [0.001-0.160]) and shopping facility accessibility (effect: 0.002, 95 % CI [0.001 - 0.101]) exhibited positive effects on BMI indirectly through decreasing TRPA duration. Negative indirect effects of sports facility accessibility (effect: -0.004, 95 % CI [-0.112 - -0.003]) and transit accessibility (effect: -0.044, 95 % CI [-0.074 - -0.002]) on BMI were observed through increasing TRPA duration. Park accessibility showed both direct (effect: -0.242, p < 0.05) and indirect (effect: -0.036, 95 % CI [-0.061 - -0.005]) negative correlations with BMI. CONCLUSION: Our findings facilitate neighborhood environment interventions regarding obesity among older adults in developing countries.