Environmental influences on healthy and active ageing: a systematic review

ABSTRACT This paper explores the evidence for environmental influences on older adult health and activity participation, identifies current knowledge gaps and limitations within this literature, and offers recommendations for future research via a systematic appraisal of 83 quantitative and qualitative studies. A Cochrane-type review procedure was followed, which incorporated structured database searches, inclusion and exclusion criteria, quality appraisal of included studies, and peer review. The review findings identify support for both personal and environmental influences on health and activity participation in later life. Reported personal influences include ethnicity and cultural norms, energy and motivation, sex, age, education, genetic heritage, self-efficacy, and personal financial circumstances. Reported environmental influences on activity participation include climate, level of pollution, street lighting, traffic conditions, accessibility and appropriateness of services and facilities, socio-economic conditions, aesthetics, pedestrian infrastructure, community life, exposure to antisocial behaviour, social network participation, environmental degradation, level of urbanism, exposure to natural settings, familiarity with local environment and others. Recommendations for future research include the need for innovative research methods; involvement of older adults as research collaborators; investigation of wider aspects of the active ageing concept; in-depth assessment of the environmental characteristics of areas; investigation of the pathways leading from environment to health and activity participation; and more theoretically informed research or increased contribution of research to theory development.