Everyday Out-of-Home Activities and Healthy Ageing: A Diary-Based Analysis of Activity Locations, Purposes and Characteristics and Their Relevance to Environmental Design for Ageing-in-Place.

Background: Maintaining diverse and outdoor activities is crucial for healthy ageing, yet activity types, environmental settings and health implications have rarely been examined together. Research has characterised activity diversity across cognitive, social and physical domains and a parallel literature has examined the environments in which activity takes place, but activities are typically analysed in isolation from one another and from their settings. What remains less well established is the joint account: work that characterises a range of activity domains as content, locates each in its actual environmental setting and relates that coupling to multidimensional wellbeing. This study takes the out-of-home (OOH) trip as its unit of analysis, since it is the smallest unit that carries an activity, a setting and a duration together, and since the settings of OOH activity are those that neighbourhood design, greenspace provision and transport policy are able to shape. It explores the associations between diverse OOH activities, their environmental contexts and health and well-being outcomes in older adults. Methods: Twenty-five community-dwelling adults aged 50 and over completed a paper activity diary recording all trips outside the home over seven consecutive days. Diaries were completed at up to four time points between winter 2022 and summer 2023, yielding 54 diaries and 742 recorded trips. The diary captured the purpose, setting, distance from home and time spent walking, in a car, on public transport and sitting for each trip, and these were examined in relation to self-reported health and well-being measures. Results: Analysis of 742 trips recorded across 54 weekly diary entries showed that trips for utilitarian and social purposes were the most common, but natural environments were the most frequent location. Recreation trips involved the longest walking times, while social engagement involved the shortest. A higher frequency of recreation and exercise trips was linked to better physical function and quality of life; social activities were associated with better perceived health. Conclusion: Social engagement appears to be a critical pathway to health, even if sedentary. Nonetheless, natural spaces are chosen environments for a range of OOH activities. We recommend neighbourhoods be designed with multifunctional natural spaces to encourage mobility during OOH trips, supporting ageing-in-place.