Perceived neighbourhood environment and accelerometer-measured moderate-to-vigorous physical activity among community-dwelling older adults in Hong Kong: a cross-sectional study

Regular physical activity is an important behavioural component of healthy ageing. Neighbourhood physical and social environments may support or constrain older adults’ opportunities and willingness to remain active, but evidence relating perceived neighbourhood conditions to objectively measured physical activity in high-density Asian cities remains limited. This study examined the associations between perceived neighbourhood environmental characteristics and accelerometer-measured moderate-to-vigorous physical activity (MVPA) among community-dwelling older adults in Hong Kong. This cross-sectional study recruited 410 adults aged 60–80 years across Hong Kong in 2024 using purposive quota sampling. Participants completed tablet-assisted interviews covering sociodemographic and health characteristics and seven perceived neighbourhood environmental domains. MVPA was measured using ActiGraph GT3X+ accelerometers worn for at least 10 h/day over four consecutive days, including one weekend day. Separate gamma generalised linear models with a log link examined associations between each environmental domain and MVPA, adjusting for sociodemographic, residential and health-related factors. Participants had a mean age of 67.5 years (standard deviation 4.9), and 80.2% were women. Median accelerometer-derived MVPA was 283.5 min/week (interquartile range 225.0). In separate adjusted models, higher perceived social cohesion (β = 0.40, p < 0.001), aesthetic quality (β = 0.32, p < 0.001), safety (β = 0.30, p < 0.001) and walking environment quality (β = 0.24, p < 0.001) were associated with higher MVPA. Perceived availability of healthy foods, neighbourhood violence and neighbourly interaction were not significantly associated with MVPA. Older age was consistently associated with lower MVPA, whereas male sex, more favourable financial circumstances and better self-rated physical health were generally associated with higher MVPA. More favourable perceptions of neighbourhood aesthetics, walking conditions, safety and social cohesion were associated with higher accelerometer-measured MVPA among community-dwelling older adults in Hong Kong. These findings suggest that age-friendly physical activity strategies in high-density cities should consider both the physical quality of pedestrian environments and the social conditions of neighbourhood life. Longitudinal and intervention studies are needed to establish temporality and determine whether changes in neighbourhood conditions lead to increased physical activity. Not applicable.