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Neighborhood environment, social participation, and physical activity in older adults with lower limb osteoarthritis: A mediation analysis

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Florian Herbolsheimer, Nadine Ungar, Erja Portegijs, Dhayana Dallmeier, Laura Schaap, Toby Smith, Brendon Stubbs, Dorly Deeg, Richard Peter, Maria Victoria Castell, Ángel Otero, Mark Edwards, Paola Siviero, Federica Limongi, Elaine Dennison, Natasja van Schoor, Nicola Veronese, Erik J. Timmermans, Suzan van der Pas

Original languageEnglish
Article number102513
JournalHealth and Place
PublishedMar 2021

Bibliographical note

Funding Information: Germany: European Union (No.:2005121) and Ministry of Science, Baden-W?rttemberg; Italy: National Research Council; The Netherlands: Dutch Ministry of Health, Welfare and Sports (project number 321175); Spain: National Fund for Health Research (05/1898; FIS_RETICEF_RD06/0013/1013; FIS_PS09/02143); Sweden: the Swedish Ministry of Higher Education; UK: The Medical Research Council of Great Britain and the Arthritis Research UK (project numbers 20665 and 4050502589); The German Research Foundation founded Florian Herbolsheimer (No. 398948032) and Nadine Ungar (No. 396651852); Toby Smith: National Institute for Health Research, UK. Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (Mage = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional analyses, neighborhood resources were associated with physical activity (r = 0.26;p <.001) and social participation (r = 0.13;p =.003). Physical activity at follow-up was associated with neighborhood resources, with this relationship mediated by social participation in people with LLOA (β = 0.018;p =.013). To promote future physical activity, opportunities to socially engage in neighborhoods need to be targeted primarily to people with LLOA.

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