Covid-19 Impacts on Physical Activity among Community-dwelling Older Adults with Memory Problems: The Moderating Role of Walkable Neighborhood Destinations.

Background and objectives: The number of people with memory problems who desire or are forced to age in place has been growing rapidly. COVID-19 has brought significant challenges to the ability of those with memory problems to stay active and age in place. This study investigated the roles of neighborhood environments in helping community-dwelling people with memory problems maintain physical activity during the COVID-19 pandemic.

Research design and methods: We used retrospective online survey data from 75 caregivers who responded on behalf of their care recipients with memory problems living in Texas communities. We used difference-in-difference (DID) estimations based on zero-inflated negative binomial regression models to examine the changes in recreational walking and moderate-to-strenuous exercise before and during the COVID-19 pandemic and whether such changes vary by diversity of walkable neighborhood destinations.

Results: In the total sample, there was a significant reduction in both recreational walking (Δ change=-45.16 min/week, p<0.001) and exercise (Δ change=-36.28 min/week, p=0.03) after the COVID-19 outbreak. The pandemic's impact on exercise varied by diversity of neighborhood destinations (DID=0.81, p=0.03). Those living in neighborhoods with diverse walkable destinations experienced less decline in physical activity compared to those living in areas with limited destinations.

Discussion and implications: These findings suggest that the impact of the COVID-19 pandemic on physical activity among people with memory problems may be partially explained by neighborhood land use characteristics. Destination-rich, mixed-use neighborhood environments can help people with memory problems stay active even during pandemics such as COVID-19 in the U.S. and potentially elsewhere.