The association between neighborhood walkability and cardiovascular diseases in older adults: a systematic review

Abstract

ABSTRACT AIM: This systematic review aims to provide a comprehensive overview of the studies investigating the association between neighborhood walkability and cardiovascular diseases (CVDs) in older adults. METHODS: PubMed was searched until 28 September 2023 for studies that met the following inclusion criteria: (1) observational or experimental original studies, (2) reporting some kind of composite walkability exposure measure, (3) reporting outcome data on CVD events or mortality due to CVD, (4) conducted in older adults (mean age above 65 years old and no adults younger than 50 years old included in the study). Only studies written in English were included. Screening, data extraction, and assessment of risk of bias was done by one reviewer. RESULTS: Five studies met the inclusion criteria and were included in this systematic review. Four out of five studies were assigned to have a good quality, and one a fair quality. In three of the five studies, a higher walkability score was associated with a significant lower risk for CVD events, varying from a 22% lower risk for cardiometabolic mortality in older women (65-85 years old; hazard ratio [HR] = 0.78 [95% confidence interval (CI) 0.63-0.97]) and a 6% lower risk for CVD mortality in older adults (65-74 years old; HR = 0.94 [95% CI 0.89-0.98]). Two studies did not find a statistically significant association. DISCUSSION: Although these results indicate a possible interaction between neighborhood walkability and CVDs in older adults, more research is needed to strengthen this evidence.