Does Perceived Neighborhood Walkability Matter? Associations with Health and Functioning Among Community-Dwelling Portuguese Older Adults

Background: To date, there are no known published studies in Portugal that link the perceived neighborhood walkability of a specific geographical area to the functional capacity and social participation of older adults living in the community. Thus, the main objective of this study, conducted in Portugal, is to examine whether the perceived neighborhood walkability is associated with functional capacity, walking confidence, social participation, and exercise self-efficacy among community-dwelling older adults, thereby contributing to the national evidence base on the influence of contextual factors on human functioning, with particular relevance to active and healthy aging. Methods: An exploratory, cross-sectional study was conducted using data from older adults (aged 50 and over) living in the community, in Portugal. A member of the research team assessed physical function using objective measures of upper and lower body function, balance and mobility. To assess the perceived neighborhood walkability, a validated questionnaire for Portuguese adults living in the community with good internal consistency (α = 0.848) was used. The walkability dimensions assessed were safety, facilities/surroundings, comfort/esthetics and accessibility/connectivity. The Pearson correlation coefficient was used to analyze the relationships between continuous variables. Differences between groups were analyzed using independent sample Student’s t-tests or analysis of variance (ANOVA) as appropriate. Results: Perceived neighborhood walkability was associated with several sociodemographic, health, and psychosocial variables. Higher educational levels and better self-perceived health were associated with more positive perceptions of walkability. Participants without urinary incontinence and osteoarthritis reported significantly higher walkability scores, particularly in the safety, facilities/surroundings, and comfort/esthetics dimensions. Older age was associated with higher scores in the facilities/surroundings dimension, whereas slower gait speed and higher anxiety levels were associated with lower perceptions in this dimension. Few significant associations were found between perceived neighborhood walkability and objective physical function measures, and these associations were generally weak. Conclusions: Overall, the findings suggest that neighborhood walkability is a multidimensional construct influenced not only by environmental characteristics but also by health status, psychological factors, and individual perceptions. These results reinforce the importance of considering contextual and environmental factors when promoting mobility, participation, and healthy aging among community-dwelling older adults.