Neighborhood Resources Associated With Active Travel in Older Adults-A Cohort Study in Six European Countries.

OBJECTIVES: To study associations between perceived neighborhood resources and time spent by older adults in active travel. METHODS: Respondents in six European countries, aged 65-85 years, reported on the perceived presence of neighborhood resources (parks, places to sit, public transportation, and facilities) with response options "a lot," "some," and "not at all." Daily active travel time (total minutes of transport-related walking and cycling) was self-reported at the baseline (n = 2,695) and 12-18 months later (n = 2,189). RESULTS: Reporting a lot of any of the separate resources (range B's = 0.19-0.29) and some or a lot for all four resources (B = 0.22, 95% confidence interval [0.09, 0.35]) was associated with longer active travel time than reporting none or fewer resources. Associations remained over the follow-up, but the changes in travel time were similar, regardless of the neighborhood resources. DISCUSSION: Perceiving multiple neighborhood resources may support older adults' active travel. Potential interventions, for example, the provision of new resources or increasing awareness of existing resources, require further study.

Association between blood pressure and mortality in a Spanish cohort of persons aged 65 years or over: a dynamic model.

INTRODUCTION AND OBJECTIVES: Few studies have used time-dependent correction to analyze the relationship between blood pressure and all-cause mortality, and to our knowledge none has been performed in older people from the Mediterranean area. This study aimed to estimate the relationship between baseline blood pressure and blood pressure as a time-dependent covariate with the risk of all-cause mortality in a population cohort of persons aged 65 or older in Spain. METHODS: Data were taken from the population-based study "Aging in Leganés" with 17 years of follow-up, launched in 1993 in a random sample (n=1560) of persons aged ≥65 years. Mortality was assessed in 2010. Cox proportional hazards models were fitted to examine the effects on mortality of blood pressure at baseline and of blood pressure as a time-dependent covariate. RESULTS: The lowest mortality was observed at baseline systolic blood pressure of 136 mmHg and time-dependent covariate value of 147 mmHg. The highest risk of mortality for time-dependent covariates occurred with systolic blood pressure <115 mmHg and >93 mmHg and diastolic blood pressure <80 mmHg. Diastolic blood pressure over 85 mmHg did not increase the risk of death. CONCLUSIONS: Based on the dynamic association between blood pressure and mortality, a U-shaped relationship was found for systolic blood pressure and a negative relationship for diastolic blood pressure and all-cause mortality. The lowest mortality corresponded to a systolic blood pressure level slightly over the diagnostic hypertension value and suggests that a value of 140 mmHg is not adequate as a diagnostic and therapeutic threshold in an elderly population.

Prevalence and incidence of hypertension in a population cohort of people aged 65 years or older in Spain.

OBJECTIVE: To estimate the prevalence and incidence of hypertension in a Spanish cohort of people aged at least 65 years with 13 years' follow-up. This is the first study to provide age-adjusted and sex-adjusted incidence rates of hypertension in a Mediterranean-based population aged 65 years or older. METHODS: Population-based longitudinal study set in the city of Leganes, Spain. The cross-sectional prevalence of hypertension was estimated using data available for the 1993, 1995, 1999, and 2006 cohorts. The incidence density (incident cases of hypertension/person-years) was calculated for 522 individuals without hypertension at baseline. Individuals were classified as hypertensive if they were taking physician-prescribed medication for hypertension or if their blood pressure was equal to or greater than 140/90 mmHg. RESULTS: Hypertension prevalence increased progressively with time, from 53.5% in 1993 to 86.2% in 2006. In all four waves, women had a higher prevalence of hypertension than men (P < 0.05). The total incidence density of hypertension was 7.6 [95% confidence interval (CI) 6.6-8.7] cases per 100 person-years of follow-up: 9.0 (95% CI 7.2-11.2) in women and 6.9 (95% CI 5.8-8.3) in men. In all age groups, the incidence density was nonsignificantly higher in women than in men (P > 0.05). CONCLUSION: Both the incidence and prevalence of hypertension in this population of people aged at least 65 years were high, and the prevalence increased dramatically over time, especially among women.