Perceived neighborhood built environment and its associations with sociodemographic characteristics among older adults in regional China.

Background: Neighborhood built environment (BE) is associated with physical activity (PA) and health-related conditions among local residents, particularly older adults. As an easily operational instrument, the Physical Activity Neighborhood Environment Scale (PANES) has been widely used to measure BE attributes related to PA globally. However, evidence remains limited on how older adults with different sociodemographic characteristics perceive local BE attributes in China. This study aimed to investigate the associations between sociodemographic characteristics and BE attributes among older residents in regional China. Methods: In this cross-sectional survey conducted in Nanjing Municipality, China, in 2023, 5,484 community-dwelling adults aged 60 + years were randomly selected. Six out of seven objectively measurable PANES core items were used to assess BE attributes, and they were treated as outcome variables. Item 1 recorded the exact housing type, while each of the remaining five items was classified as "strongly/somewhat disagree" or "strongly/somewhat agree" based on a 4-point Likert scale. The explanatory variables were the classical sociodemographic characteristics. Mixed-effects multivariate logistic regression models were used to investigate the associations between sociodemographic characteristics and BE attributes. Results: After adjusting for potential confounders, suburban residents were less likely to perceive PA-favorable commercial facilities, public transportation transit/stops, sidewalks on streets, shared paths for cycles and pedestrians, and free/low-cost recreational facilities. Blue-collar workers were less likely to perceive PA-supportive sidewalks on streets and shared paths for cyclists and pedestrians. Participants with middle-level educational attainment were more likely to report PA-friendly commercial facilities, sidewalks, shared paths for cycles and pedestrians, and free/low-cost recreational facilities, whereas individuals with a spouse/partner tended to report sidewalks and shared paths for cycles and pedestrians. Interestingly, participants aged 70-79 years were less likely to live in a single house, and no link was observed between sex and perceived BE attributes. Conclusion: Residential location, education, occupation, and marital status were all associated with perceived BE attributes among older residents in regional China; however, age was only associated with the type of housing. This study has important public health implications, suggesting that sociodemographic characteristics may serve as helpful markers for screening older community-dwelling adults who may perceive PA-supportive BE attributes in regional China.