Background: An online version of the Microscale Audit of Pedestrian Streetscapes (Abbreviated) tool was adapted to virtually audit built environment features supportive of physical activity. The current study assessed inter-rater reliability of MAPS Online between in-person raters and online raters unfamiliar with the regions.

Methods: In-person and online audits were conducted for a total of 120 quarter-mile routes (60 per site) in Phoenix, AZ and San Diego, CA. Routes in each city included 40 residential origins stratified by walkability and SES, and 20 commercial centers. In-person audits were conducted by raters residing in their region. Online audits were conducted by raters in the alternate location using Google Maps (Aerial and Street View) images. The MAPS Abbreviated Online tool consisted of four sections: overall route, street segments, crossings and cul-de-sacs. Items within each section were grouped into subscales, and inter-rater reliability (ICCs) was assessed for subscales at multiple levels of aggregation.

Results: Online and in-person audits showed excellent agreement for overall positive microscale (ICC = 0.86, 95% CI [0.80, 0.90]) and grand scores (ICC = 0.93, 95% CI [0.89, 0.95]). Substantial to near-perfect agreement was found for 21 of 30 (70%) subscales, valence, and subsection scores, with ICCs ranging from 0.62, 95% CI [0.50, 0.72] to 0.95, 95% CI [0.93, 0.97]. Lowest agreement was found for the aesthetics and social characteristics scores, with ICCs ranging from 0.07, 95% CI [−0.12, 0.24] to 0.27, 95% CI [0.10, 0.43].

Conclusions: Results support use of the MAPS Abbreviated Online tool to reliably assess microscale neighborhood features that support physical activity and may be used by raters residing in different geographic regions and unfamiliar with the audit areas.

Background: High levels of physical activity (PA) and cardiorespiratory fitness (CRF) are each associated with a favorable cardiovascular disease (CVD) risk profile. However, the relationship between CRF and obesity is still inconsistent across studies, and there has been no thorough exploration of the independent contribution of CRF to different CVD risk factors in Chinese women. This study investigated the relationship between CRF and CVD risk factors in 40–49 year old women in Beijing.

Methods: The study included 231 urban-dwelling asymptomatic 40–49 year old women. Body mass index (BMI), body fat percentage (BF%), blood glucose, blood lipids, blood pressure, and pulse wave velocity (PWV) were measured at rest. Cycle ergometer exercise tests were conducted to assess CRF as indicated by maximal oxygen uptake (VO[subscript 2max]). Participants were categorized into three CRF levels (low, moderate and high).

Results: High CRF level was associated with significantly less BF%, lower PWV, and higher weekly physical activity compared with low and moderate CRF (P < 0.05). Compared to high CRF, the odds ratios for having ≥3 main CVD risk factors (overweight, hypertension, and dyslipidemia) in low and moderate CRF were 2.09 (95% CI: 1.48-2.94) and 1.84 (95% CI: 1.29-2.62), respectively. The proportion of participants with clinical ST segment depression and prolonged QTC interval during cycle ergometer testing was significantly higher in women with low CRF.

Conclusions: Overall, Chinese middle-aged women demonstrated a moderate level of CRF. CRF was independently associated with CVD risk factors, including overweight, hypertension, dyslipidemia, arterial stiffness, and abnormal ECG during exercise, with the least fit women exhibiting the highest number of CVD risk factors.

Background and purpose: Regular physical activity (PA) provides benefits for cognitive health and helps to improve or maintain quality of life among older adults. Objective PA measures have been increasingly used to overcome limitations of self-report measures. The purpose of this study was to investigate the association of objectively measured PA and sedentary time with cognitive function among older adults.

Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.

Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).

Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.