How the perceived neighbourhood environment influences active living in older dwellers of an Asian ultra-dense metropolis

The way older adults perceive their neighbourhood environment may determine their levels of physical activity. We examined the associations of perceived neighbourhood environmental attributes with accelerometry-assessed and self-reported physical activity and sedentary time in Hong Kong Chinese older adults. In doing so, we estimated the inter-relationships among perceived environmental attributes, the mediating role of physical activity in the environment-sedentary time nexus and the moderating role of sex. We used data from the Active Lifestyle and the Environment in Chinese Seniors (ALECS) project collected on older adults (N = 909; >= 65 years) living in neighbourhoods varying in walkability and socio-economic status (71 % response rate). Self-reported physical activity and perceived neighbourhood attributes were assessed with validated questionnaires. Accelerometer-based physical activity and sedentary time were collected in 402 participants. Older adults who perceived their neighbourhood to be walkable, safe, aesthetically pleasing and equipped with public sitting facilities engaged in more physical activity and less sedentary time. Curvilinear relations of perceived residential density and activity-friendly urban design features indicated that extreme levels of density may not be optimal for older adults to adopt an active lifestyle because they do not provide sufficient space for sitting facilities and greenery and do not result in better perceptions of neighbourhood walkability when compared to areas with moderate-to-high levels of density. Creative solutions for the incorporation of greenery and public places for sitting in megacities are needed.