Mobility restrictions in older adults are common and increase the likelihood of negative health outcomes and premature mortality. The effect of built environment on mobility in older populations, among whom environmental effects may be strongest, is the focus of a growing body of the literature. We reviewed recent research (1990–2010) that examined associations of objective measures of the built environment with mobility and disability in adults aged 60 years or older. Seventeen empirical articles were identified. The existing literature suggests that mobility is associated with higher street connectivity leading to shorter pedestrian distances, street and traffic conditions such as safety measures, and proximity to destinations such as retail establishments, parks, and green spaces. Existing research is limited by differences in exposure and outcome assessments and use of cross-sectional study designs. This research could lead to policy interventions that allow older adults to live more healthy and active lives in their communities.

In addition to greater cross-disciplinary research, there is a need for new approaches to training clinicians and investigators, which integrate concepts and methodologies from individual disciplines, focus on emerging methodologies, and prepare investigators to assess complex, multisystem associations.

Objective To examine cross-sectional associations between mobility with or without disability and social engagement in a community-based sample of older adults Methods Social engagement of participants (n=676) was outside the home (participation in organizations and use of senior centers) and in home (talking by phone and use of internet). Logistic or proportional odds models evaluated the association between social engagement and position in the disablement process (no mobility limitations, mobility limitations/no disability, and mobility limitations/disability). Results Low mobility was associated with lower level of social engagement of all forms (OR=0.59, CI: 0.41–0.85 for organizations; OR=0.67, CI: 0.42–1.06 for senior center; OR=0.47, CI: 0.32–0.70 for phone; OR=0.38, CI: 0.23–0.65 for internet). For social engagement outside the home, odds of engagement were further reduced for individuals with disability. Discussion Low mobility is associated with low social engagement even in the absence of disability; associations with disability differed by type of social engagement.

Objective To evaluate the prevalence of migraine/severe headaches in those with and without general obesity and abdominal obesity (Abd-O) and the effect of gender and age on this relationship. Background General, or total body obesity (TBO), as estimated by body mass index, is a risk factor for migraine chronification. However, there are conflicting data as to whether TBO is associated with migraine prevalence. Abd-O has been shown to be a better predictor of various disease states than TBO, but has not been evaluated in general population studies in association with migraine. Methods Data from a general population survey, the National Health and Nutrition Examination Survey, were used to obtain demographics, self-report of migraine/severe headaches and measured body mass indices, including height, weight, and waist circumference. All analyses were stratified by age and gender and multivariate analyses were determined through use of logistic regression models. Results A total of 21,783 participants were included in the analysis. Between 20-55 years of age, the prevalence of migraine was increased in both men and women with TBO as compared with those without, (P ≤ .001). Migraine was also more prevalent in those with Abd-O as compared with those without (men: 20.1% vs 15.9%, P < .001; women: 36.9% vs 28.8.2%, P < .001).After 55 years of age, the prevalence of migraine in men was no longer associated with either TBO or Abd-O. Similarly, after 55 years of age, the prevalence of migraine in women was no longer associated with TBO. However, in women older than 55 years, the prevalence of migraine was decreased in those with Abd-O as compared with those without Abd-O (14.4% vs 17.4%, P < .05). After adjusting for demographics, cardiovascular risk factors and Abd-O, results were similar for the association between migraine prevalence and TBO in both younger and older men and women.After adjusting for demographics, cardiovascular risk factors and TBO, migraine prevalence was no longer associated with Abd-O in younger men, but remained associated with an increased odds ratio of having migraine in younger women, as well as a decreased odds ratio in older women. Conclusion The relationship between migraine and obesity varies by age, gender, and adipose tissue distribution (eg, TBO vs Abd-O). In men and women ≤55 years old, migraine prevalence is increased in those with TBO, independent of Abd-O. In addition, in men and women ≤55 years old, migraine prevalence is increased in those with Abd-O; and in women this association is independent of TBO. In men older than 55 years, migraine is not associated with either TBO or Abd-O. However, in women older than 55 years, migraine prevalence is decreased in those with Abd-O and is independent of TBO.