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

and for the LIFE Study Investigators

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3 Scopus citations

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

Original languageEnglish (US)
Article number157
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume12
Issue number1
DOIs
StatePublished - Dec 18 2015

Funding

The Lifestyle Interventions and Independence for Elders Study is funded by a National Institutes of Health (NIH)/National Institute on Aging Cooperative Agreement (U01 AG22376), a supplement from the National Heart, Lung and Blood Institute (3U01AG022376-05A2S), and is sponsored in part by the Intramural Research Program, National Institute on Aging, NIH. Dr. Gill is the recipient of an Academic Leadership Award (K07AG043587) from the National Institute on Aging. The research is partially supported by the Claude D. Pepper Older Americans Independence Centers at the University of Florida (1 P30 AG028740), Wake Forest University (1 P30 AG21332), Tufts University (1P30AG031679), University of Pittsburgh (P30 AG024827), and Yale University (P30AG021342) and the NIH/NCRR CTSA at Stanford University (UL1 RR025744), at University of Florida (U54RR025208), and at Yale University (UL1 TR000142). Tufts University investigators are also supported by the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1), and Dr. Fielding is supported by the U.S. Department of Agriculture, under Agreement No. 58-1950-0-014. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the U.S. Dept. of Agriculture. 58-1950-0-014. Any opinions, findings, conclusion, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Dept of Agriculture. This research is also supported by the Boston Claude D. Pepper Older Americans Independence Center (1P30AG031679) and the Boston Rehabilitation Outcomes Center (1R24HD065688-01A1). University of Florida, Gainesville, FL Todd M. Manini, PhD – Field Center Principal Investigator Marco Pahor, MD – Field Center CoInvestigator Stephen D. Anton, PhD Thomas W. Buford, PhD Michael Marsiske, PhD Susan G. Nayfield, MD, MSc Bhanuprasad D. Sandesara, MD Mieniecia L. Black, MS William L. Burk, MS Brian M. Hoover, BS Jeffrey D. Knaggs, BS William C. Marena, MT, CCRC Irina Korytov, MD Stephanie D. Curtis, BS Megan S. Lorow, BS Chaitalee S. Goswami Melissa A. Lewis Michelle Kamen BS Jill N. Bitz Brian K. Stanton, BS Tamika T. Hicks, BS Charles W. Gay, DC Chonglun Xie, MD (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Holly L. Morris, MSN, RN, CCRC (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Floris F. Singletary, MS, CCC-SLP (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Jackie Causer, BSH, RN (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Susan Yonce, ARNP (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Katie A. Radcliff, M.A. (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Mallorey Picone Smith, B.S. (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Jennifer S. Scott, B.S. (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Melissa M. Rodriguez B.S. (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Margo S. Fitch, P.T. (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Mendy C. Dunn, BSN (Assessment) (Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) Jessica Q. Schllesinger, B.S. Brooks Rehabilitation Clinical Research Center, Jacksonville, FL) This research is partially supported by the University of Florida Claude D. Pepper Older Americans Independence Center (1 P30 AG028740). University of Pittsburgh, Pittsburgh, PA Anne B. Newman, MD, MPH – Field Center Principal Investigator Stephanie A. Studenski, MD, MPH – Field Center Co-Investigator Bret H. Goodpaster, PhD Oscar Lopez, MD Nancy W. Glynn, PhD Neelesh K. Nadkarni, MD, PhD Diane G. Ives, MPH Mark A. Newman, PhD George Grove, MS Kathy Williams, RN, BSEd, MHSA Janet T. Bonk, MPH, RN Jennifer Rush, MPH Piera Kost, BA (deceased) Pamela Vincent, CMA Allison Gerger, BS Jamie R. Romeo, BS Lauren C. Monheim, BS The Pittsburgh Field Center is partially supported by the Pittsburgh Claude D. Pepper Older Americans Independence Center (P30 AG024827). Wake Forest University, Winston Salem, NC Stephen B. Kritchevsky, Ph.D. – Field Center Principal Investigator Anthony P. Marsh, PhD – Field Center Co-Principal Investigator Tina E. Brinkley, PhD Jamehl S. Demons, MD Kaycee M. Sink, MD, MAS Kimberly Kennedy, BA, CCRC Rachel Shertzer-Skinner, MA, CCRC Abbie Wrights, MS Rose Fries, RN, CCRC Deborah Barr, MA, RHEd, CHES The Wake Forest University Field Center is, in part, supported by the Claude D. Pepper Older Americans Independence Center (1 P30 AG21332). Yale University, New Haven, CT Thomas M. Gill, M.D. – Field Center Principal Investigator Robert S. Axtell, PhD, FACSM – Field Center CoPrincipal Investigator (Southern Connecticut State University, Exercise Science Department) Susan S. Kashaf, MD, M.P.H. (VA Connecticut Healthcare System) Nathalie de Rekeneire, MD, MS Joanne M. McGloin, MDiv, MS, MBA Raeleen Mautner, PhD Sharon M. Huie-White, MPH Luann Bianco, BA Janice Zocher Karen C. Wu, RN Denise M. Shepard, RN, MBA Barbara Fennelly, MA, RN Rina Castro, LPN Sean Halpin, MA Matthew Brennan, MA Theresa Barnett, MS, APRN Lynne P. Iannone, MS, CCRP Maria A. Zenoni, M.S. Julie A. Bugaj, MS Christine Bailey, MA Peter Charpentier, MPH Geraldine Hawthorne-Jones Bridget Mignosa Lynn Lewis Dr. Gill is the recipient of an Academic Leadership Award (K07AG3587) from the National Institute on Aging. The Yale Field Center is partially supported by the Claude D. Pepper Older Americans Independence Center (P30AG021342). Cognition Coordinating Center, Wake Forest University, Winston Salem, NC Jeff Williamson, MD, MHS – Center Principal Investigator Kaycee M Sink, MD, MAS – Center Co-Principal Investigator Hugh C. Hendrie, MB, ChB, DSc (Indiana University) Stephen R. Rapp, PhD Joe Verghese, MB, BS (Albert Einstein College of Medicine of Yeshiva University) Nancy Woolard Mark Espeland, PhD Janine Jennings, PhD Valerie K. Wilson, MD Electrocardiogram Reading Center, University of Florida, Gainesville, FL Carl J. Pepine MD, MACC Mario Ariet, PhD Eileen Handberg, PhD, ARNP Daniel Deluca, BS James Hill, MD, MS, FACC Anita Szady, MD Spirometry Reading Center, Yale University, New Haven, CT Geoffrey L. Chupp, MD Gail M. Flynn, RCP, CRFT Thomas M. Gill, MD John L. Hankinson, PhD (Hankinson Consulting, Inc.) Carlos A. Vaz Fragoso, MD Dr. Fragoso is the recipient of a Career Development Award from the Department of Veterans Affairs. Cost Effectiveness Analysis Center Erik J. Groessl, PhD (University of California, San Diego and VA San Diego Healthcare System) Robert M. Kaplan, PhD (Office of Behavioral and Social Sciences Research, National Institutes of Health) The Lifestyle Interventions and Independence for Elders Study is funded by a National Institutes of Health/ National Institute on Aging Cooperative Agreement #UO1 AG22376 and a supplement from the National Heart, Lung and Blood Institute 3U01AG022376-05A2S, and sponsored in part by the Intramural Research Program, National Institute on Aging, NIH. Administrative Coordinating Center, University of Florida, Gainesville, FL Marco Pahor, MD – Principal Investigator of the LIFE Study Jack M. Guralnik, MD, PhD – CoInvestigator of the LIFE Study (University of Maryland School of Medicine, Baltimore, MD) Stephen D. Anton, PhD Thomas W. Buford, PhD Christiaan Leeuwenburgh, PhD Susan G. Nayfield, MD, MSc Todd M. Manini, PhD Connie Caudle Lauren Crump, MPH Latonia Holmes Jocelyn Lee, PhD Ching-ju Lu, MPH This research is partially supported by the University of Florida Claude D. Pepper Older Americans Independence Center (1 P30 AG028740). Data Management, Analysis and Quality Control Center, Wake Forest University, Winston Salem, NC Michael E. Miller, Ph.D. – DMAQC Principal Investigator Mark A. Espeland, Ph.D. – DMAQC CoInvestigator Walter T. Ambrosius, PhD William Applegate, MD Daniel P. Beavers, PhD, MS Robert P. Byington, PhD, MPH, FAHA Delilah Cook, CCRP Curt D. Furberg, MD, PhD Lea N. Harvin, BS Leora Henkin, MPH, Med John Hepler, MA Fang-Chi Hsu, PhD Kathy Joyce Laura Lovato, MS Juan Pierce, AB Wesley Roberson, BSBA Julia Robertson, BS Julia Rushing, BSPH, MStat Scott Rushing, BS Cynthia L. Stowe, MPM Michael P. Walkup, MS Don Hire, BS W. Jack Rejeski, PhD Jeffrey A. Katula, PhD, MA Peter H. Brubaker, PhD Shannon L. Mihalko, PhD Janine M. Jennings, PhD National Institutes of Health, Bethesda, MD Evan C. Hadley, MD (National Institute on Aging) Sergei Romashkan, MD, PhD (National Institute on Aging) Kushang V. Patel, PhD (National Institute on Aging) National Heart, Lung and Blood Institute, Bethesda, MD Denise Bonds, MD, MPH Field Centers Northwestern University, Chicago, IL Mary M. McDermott, MD – Field Center Principal Investigator Bonnie Spring, PhD – Field Center Co-Investigator Joshua Hauser, MD – Field Center Co-Investigator Diana Kerwin, MD – Field Center Co-Investigator Kathryn Domanchuk, BS Rex Graff, MS Alvito Rego, MA Pennington Biomedical Research Center, Baton Rouge, LA Timothy S. Church, MD, PhD, MPH – Field Center Principal Investigator Steven N. Blair, PED (University of South Carolina) Valerie H. Myers, PhD Ron Monce, PA-C Nathan E. Britt, NP Melissa Nauta Harris, BS Ami Parks McGucken, MPA, BS Ruben Rodarte, MBA, MS, BS Heidi K. Millet, MPA, BS Catrine Tudor-Locke, PhD, FACSM Ben P. Butitta, BS Sheletta G. Donatto, MS, RD, LDN, CDE Shannon H. Cocreham, BS Stanford University, Palo Alto, CA Abby C. King, Ph.D. – Field Center Principal Investigator Cynthia M. Castro, PhD William L. Haskell, PhD Randall S. Stafford, MD, PhD Leslie A. Pruitt, PhD Veronica Yank, MD Kathy Berra, MSN, NP-C, FAAN Carol Bell, NP Rosita M. Thiessen Kate P. Youngman, MA Selene B. Virgen, BAS Eric Maldonado, BA Kristina N. Tarin, MS, CSCS Heather Klaftenegger, BS Carolyn A. Prosak, RD Ines Campero, BA Dulce M. Garcia, BS José Soto, BA Linda Chio, BA David Hoskins, MS Tufts University, Boston, MA Roger A. Fielding, PhD – Field Center Principal Investigator Miriam E. Nelson, PhD Sara C. Folta, PhD Edward M. Phillips, MD Christine K. Liu, MD Erica C. McDavitt, MS Kieran F. Reid, PhD, MPH Dylan R. Kirn, BS Evan P. Pasha, BS Won S. Kim, BS Julie M. Krol, MS Vince E. Beard, BS Eleni X. Tsiroyannis, BS Cynthia Hau, BS, MPH Dr. Fielding's contribution is partially supported by the U.S. Department of Agriculture, under Agreement No.

Keywords

  • Aging
  • Disability
  • Homophily
  • Mobility
  • Neighborhood
  • Obesity
  • Perceived environment
  • Race/ethnicity
  • Recursive partitioning
  • Residential density

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Nutrition and Dietetics

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