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Int J Behav Nutr Phys Act. 2015 Dec 18;12:157. doi: 10.1186/s12966-015-0322-1.

An observational study identifying obese subgroups among older adults at increased risk of mobility disability: do perceptions of the neighborhood environment matter?

Collaborators (202)

Pahor M, Guralnik JM, Anton SD, Buford TW, Leeuwenburgh C, Nayfield SG, Manini TM, Caudle C, Crump L, Lee J, Lu CJ, Espeland MA, Ambrosius WT, Applegate W, Beavers DP, Byington RP, Cook D, Furberg CD, Harvin LN, Henkin L, Hepler J, Hsu FC, Joyce K, Lovato L, Pierce J, Roberson W, Robertson J, Rushing J, Rushing S, Stowe CL, Walkup MP, Hire D, Rejeski WJ, Katula JA, Brubaker PH, Mihalko SL, Jennings JM, Hadley EC, Romashkan S, Patel KV, Bonds D, McDermott MM, Spring B, Hauser J, Kerwin D, Domanchuk K, Graff R, Rego A, Church TS, Blair SN, Myers VH, Monce R, Britt NE, Harris MN, McGucken AP, Rodarte R, Millet HK, Tudor-Locke C, Butitta BP, Donatto SG, Cocreham SH, King AC, Castro CM, Haskell WL, Stafford RS, Pruitt LA, Yank V, Berra K, Bell C, Thiessen RM, Youngman KP, Virgen SB, Maldonado E, Tarin KN, Klaftenegger H, Prosak CA, Campero I, Garcia DM, Soto J, Chio L, Hoskins D, Fielding RA, Nelson ME, Folta SC, Phillips EM, Liu CK, McDavitt EC, Reid KF, Kirn DR, Pasha EP, Kim WS, Krol JM, Beard VE, Tsiroyannis EX, Hau C, Manini TM, Pahor M, Anton SD, Buford TW, Marsiske M, Nayfield SG, Sandesara BD, Black ML, Burk WL, Hoover BM, Knaggs JD, Marena WC, Korytov I, Curtis SD, Lorow MS, Goswami CS, Lewis MA, Kamen M, Bitz JN, Stanton BK, Hicks TT, Gay CW, Xie C, Morris HL, Singletary FF, Causer J, Yonce S, Radcliff KA, Smith MP, Scott JS, Rodriguez MM, Fitch MS, Dunn MC, Schllesinger JQ, Newman AB, Studenski SA, Goodpaster BH, Lopez O, Glynn NW, Nadkarni NK, Ives DG, Newman MA, Grove G, Williams K, Bonk JT, Rush J, Kost P, Vincent P, Gerger A, Romeo JR, Monheim LC, Kritchevsky SB, Marsh AP, Brinkley TE, Demons JS, Sink KM, Kennedy K, Shertzer-Skinner R, Wrights A, Fries R, Barr D, Gill TM, Axtell RS, Kashaf SS, de Rekeneire N, McGloin JM, Mautner R, Huie-White SM, Bianco L, Zocher J, Wu KC, Shepard DM, Fennelly B, Castro R, Halpin S, Brennan M, Barnett T, Iannone LP, Zenoni MA, Bugaj JA, Bailey C, Charpentier P, Hawthorne-Jones G, Mignosa B, Lewis L, Williamson J, Sink KM, Hendrie HC, Rapp SR, Verghese J, Woolard N, Espeland M, Jennings J, Wilson VK, Pepine CJ, Ariet M, Handberg E, Deluca D, Hill J, Szady A, Chupp GL, Flynn GM, Gill TM, Hankinson JL, Vaz Fragoso CA, Groessl EJ, Kaplan RM.

Author information

1
Health Research & Policy, and Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 259 Campus Drive, HRP Redwood Building, Room T221, Stanford, CA, USA. king@stanford.edu.
2
Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. deborah.salvo@uth.tmc.edu.
3
Michael and Susan Dell Center for Healthy Living, the University of Texas Health Science Center at Houston, School of Public Health (Austin Regional Campus), Austin, TX, USA. deborah.salvo@uth.tmc.edu.
4
Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. jorge.banda@stanford.edu.
5
Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. david.ahn@stanford.edu.
6
Department of Medicine, Yale University School of Medicine, New Haven, CT, 06504, USA. Thomas.gill@yale.edu.
7
Department of Biostatistical Sciences, Lake Forest School of Medicine, Winston-Salem, NC 27157, USA. mmiller@wakehealth.edu.
8
Healthy Aging Research Program, University of Pittsburgh, Pittsburgh, PA, 15213, USA. mmiller@wakehealth.edu.
9
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 02111, USA. roger.fielding@tufts.edu.
10
Healthy Aging Research Program, University of Pittsburgh, Pittsburgh, PA, 15213, USA. CAS271@pitt.edu.
11
Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, 29208, USA. MOOREDS4@mailbox.sc.edu.
12
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 02111, USA. sara.folta@tufts.edu.
13
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. bspring@northwestern.edu.
14
Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, 32608, USA. tmanini@ufl.edu.
15
Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, 32608, USA. mpahor@ufl.edu.

Abstract

BACKGROUND:

Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitations associated with subsequent disability.

METHODS:

The Lifestyle Interventions and Independence for Elders (LIFE) trial dataset (n = 1600) was used to explore the associations between perceived built environment variables and baseline obesity levels. Age-stratified recursive partitioning methods were applied to identify distinct subgroups with varying obesity prevalence.

RESULTS:

Among participants aged 70-78 years, four distinct subgroups, defined by combinations of perceived environment and race-ethnicity variables, were identified. The subgroups with the lowest obesity prevalence (45.5-59.4%) consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4%) consisted of non-African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. Overall support for the partitioned subgroupings was obtained using mixed model regression analysis.

CONCLUSIONS:

The results suggest that, in combination with race/ethnicity, features of the perceived neighborhood built and social environments differentiated distinct groups of vulnerable older adults from different age strata that differed in obesity prevalence. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation.

TRIAL REGISTRATION:

Clinicaltrials.gov Identifier =  NCT01072500.

PMID:
26684894
PMCID:
PMC4683911
DOI:
10.1186/s12966-015-0322-1
[Indexed for MEDLINE]
Free PMC Article

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