Effects of environmental and social facilitators on physical activity among older adults: A population-based study in São Paulo, Brazil

INTRODUCTION: Regular physical activity is essential for healthy aging, but adherence among older adults remains low. Few studies have examined the influence of environmental and social factors on activity. OBJECTIVE: To analyze the associations between facilitators ‒ built environment, safety, social support, and public programs ‒ and physical activity among older adults. METHOD: Data from 1,017 individuals aged 60-years or older from the 2015 São Paulo Health Survey were analyzed. Physical activity (≥150 min/week) was assessed using the IPAQ. Poisson regression estimated associations with individual facilitators and a cumulative score. RESULTS: Overall, 30.1% achieved ≥150 min/week of physical activity. Awareness of public programs was associated with a higher likelihood of physical activity (PR = 1.63; 95% CI 1.28-2.09). Older adults living in the Southeast (PR = 1.55; 95% CI 1.09-2.20) and East zones (PR = 1.54; 95% CI 1.04-2.27) were more likely to achieve ≥150 min/week than those living in the North. Compared with those reporting no facilitators, the likelihood of meeting recommendations increased with the number of facilitators: PR = 1.48 (95% CI 1.00-2.19) for three facilitators, PR = 2.19 (95% CI 1.44-3.32) for four, and PR = 2.39 (95% CI 1.19-4.78) for five facilitators. CONCLUSION: Physical activity among older adults was associated with awareness of public programs and area of residence, suggesting territorial differences in opportunities for physical activity across São Paulo. Additionally, a cumulative pattern was observed, suggesting that the combined presence of environmental and social facilitators may further increase engagement in physical activity.