Factors Associated With Outdoor Frequency Among U.S. Community-Dwelling Medicare Beneficiaries: A Cross-Sectional Study.
Justine S Sefcik, Martha C Coates, Darina V Petrovsky and 10 others
PMID 39836770WHAT IT FOUND
Most older adults went outside daily, but probable dementia, needing help, mobility devices, lower physical performance, and street disorder were linked to rarely or never going outside.
Key findings
01Older adults with probable dementia had greater odds of going outside rarely or never compared with those without dementia.
02Participants who needed help going outside had greater odds of going outside rarely or never.
03Street disorder and continuous sidewalks were associated with greater odds of going outside rarely or never.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured associations at one time, so it cannot show that dementia, mobility aids, street disorder, or sidewalks caused less time outdoors. Outdoor frequency was self-reported, which may be inaccurate, especially for people with memory problems. Neighborhood conditions were observed by staff using an unvalidated checklist, and sidewalk condition, street connectivity, and amenities were not measured. The analysis excluded people on hospice, in residential or nursing care, and proxy respondents, so it does not cover all Medicare beneficiaries. Asian, Pacific Islander, Native Hawaiian, and more than one race groups were too small to examine separately. Weather, season, activity type, and time spent outdoors were not available. Dementia status was based on NHATS cognitive testing, not gold-standard clinical assessment.
Declared interests
The authors declared no conflicts of interest. The paper is listed as supported by NIH extramural funding.
The easy way to misread this
Do not conclude that dementia, mobility aids, street disorder, or continuous sidewalks cause older adults to stay indoors. This cross-sectional study only shows associations, and continuous sidewalks may reflect unmeasured neighborhood conditions rather than a barrier.