Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study.

To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Community-dwelling 75-90 -year-old persons ( = 848) reported environmental outdoor mobility facilitators and barriers at baseline. Modifications in walking 2 km (adaptive, maladaptive, or no) were assessed at baseline and one and two years later. Outdoor mobility facilitators were more often reported by those not using modifications or using adaptive versus maladaptive walking modifications. Differences in health and physical capacity explained most of the associations between outdoor mobility barriers and walking modifications. Perceived outdoor environment did not systematically predict future adaptive or maladaptive walking modifications. Facilitators may compensate the declined physical capacity and alleviate the strain of walking longer distances by enabling the use of adaptive walking modifications, while lack of such facilitators fuels avoidance of walking longer distances.