The Effect of Outdoor Recreation on Quality of Life and Well-Being: A Systematic Review in Elders

Abstract

As the aging population increases, the quality of life and well-being of elders become an issue of importance for the entire society. The positive effect of outdoor recreation on lifelong health in elderly individuals is widely accepted. This review study was conducted to examine the effects of elders’ participation in outdoor recreation on quality of life and well-being. The study was conducted as a systematic review method using the PRISMA protocol. The research data were obtained from Elsevier-Science Direct, Emerald, Scopus, Taylor and Francis, Web of Science and Sage databases and includes a total of 64 English papers. The findings revealed the positive effects of participation duration in outdoor activities on elderly individuals. However, there are many problems that prevent elderly individuals from participating in activities and new studies examining those problems are required. The results point out that decision-makers and policy makers need to determine strategies for design principles and managerial practices to facilitate the participation of older individuals in outdoor recreation.

Keywords

• Quality of life
• Well-being
• Outdoor recreation
• Elder population
• Systematic quantitative literature review
• PRISMA protocol

Açık Alan Rekreasyonunun Yaşam Kalitesi ve İyi Oluşa Etkisi: Yaşlı Yetişkinlerde Sistematik İnceleme

Öz

Yaşlanan nüfus arttıkça yaşlı yetişkinlerin yaşam kalitesi ve iyi oluş durumu, tüm toplum açısından önem taşıyan bir konu haline gelmektedir. Açık alan rekreasyonunun, yaşlı bireylerde yaşam boyu sağlığı olumlu yönde etkilediği görüşü kabul görmektedir. Bu derleme araştırması, yaşlı yetişkinlerde açık alan rekreasyonuna katılımın yaşam kalitesi ve iyi oluş durumuna etkisini incelemek amacıyla gerçekleştirilmiştir. Çalışma, PRISMA protokolünden yararlanılarak sistematik derleme yöntemi türünde yürütülmüştür. Araştırma verileri, Elsevier- Science Direct, Emerald, Scopus, Taylor and Francis, Web of Science ve Sage veri tabanlarından elde edilmiş toplam 64 İngilizce makaleyi kapsamaktadır. Analiz bulguları, yaşlı bireylerde açık alan aktivitelerine katılım süresi arttıkça sağlık üzerine olumlu sonuçlar yarattığını, ancak yaşlı bireylerin aktivitelere katılımını engelleyen pek çok sorun bulunduğunu ve bu sorunları da inceleyen yeni çalışmalara ihtiyaç olduğunu ortaya koymaktadır. Sonuçlar, karar vericilerin ve politika belirleyicilerin yaşlı bireylerin açık alan rekreasyonuna katılımlarını kolaylaştıracak tasarım ilkeleri ve yönetsel uygulamalara yönelik strateji belirlemeleri gerektiğine dikkat çekmektedir.

Anahtar Kelimeler

• Yaşam kalitesi
• İyi oluş
• Açık alan rekreasyonu
• Yaşlı yetişkinler
• Sistematik alanyazın taraması
• PRISMA protokolü

References

1. Asan, K., Alrawadieh, Z. ve Altinay, L. (2024). Connectedness to Nature and Life Satisfaction of Seniors: the Mediating Effects of Tourist Experience and Tourist Well-being, Current Issues in Tourism, 27(9): 1496-1512.
2. Baker, D. A. ve Palmer, R. J. (2006). Examining the Effects of Perceptions of Community and Recreation Participation on Quality of Life, Social Indicators Research, 75: 395-418.
3. Bell, S., Tyrväinen, L., Sievänen, T., Pröbstl, U. ve Simpson, M. (2007). Outdoor Recreation and Nature Tourism: A European Perspective, Living Reviews in Landscape Research, 1(2): 1-46.
4. Bianchi, C. ve Drennan. J. (2021). Customer-to-Customer Interactions (CCIs) Among Older Customers of Outdoor Recreational Services: Implications for Well-being, Journal of Outdoor Recreation and Tourism, 35: 100348.
5. Bigelow, D.A., McFarland, B.H. ve Olson, M.H. (1991). Quality of Life of Community Mental Health Program Clients: Validating a Measure, Community Mental Health Journal, 27(1): 43-56.
6. Blackman, T., Van Schaik, P. ve Martyr, A. (2007). Outdoor Environments for People with Dementia: An Exploratory Study Using Virtual Reality, Ageing and Society, 27: 811-825.
7. Bowling, A., Banister, D., Sutton, S. Evans, O. ve Windsor, J. (2002). A Multidimensional Model of the Quality of Life in Older Age, Aging and Mental Health, 6(4): 355-371.
8. Boyes, M. (2013). Outdoor Adventure and Successful Ageing, Ageing and Society, 33: 644-665.

9. Bures, R. M. (1997). Migration and the Life Course: Is There a Retirement Transition?, International Journal of Population Geography, 3(2): 109-119.
10. Cao, Y., Wu, H., Wang, H., Qu, Y., Zeng, Y. ve Mu, X. (2023). How Do Block Built Environments Affect Daily Leisure Walking among the Elderly? A Empirical Study of Gaoyou, China, Sustainability,15: 257.
11. Chang, P. J. (2020). Effects of the Built and Social Features of Urban Greenways on the Outdoor Activity of Older Adults, Landscape and Urban Planning, 204:10392.
12. Chao, S. F. (2016). Outdoor Activities and Depressive Symptoms in Displaced Older Adults Following Natural Disaster: Community Cohesion as Mediator and Moderator, Aging and Mental Health, 20(9): 940-947.
13. Chen, T. ve Janke, M. C. (2020). Promoting Active Living among Aging Populations through Outdoor Recreation: An Integrative Review, Leisure Sciences, 42(1): 85-99.
14. Chen, X., Zhu, H. ve Yin, D. (2020). Everyday Life Construction, Outdoor Activity and Health Practice among Urban Empty Nesters and Their Companion Dogs in Guangzhou, China, International Journal Environment Research Public Health, 17: 4091.
15. Chi, O. H., Denton, G. ve Gursoy, D. (2020). Artificially Intelligent Device Use in Service Delivery: A Systematic Review, Synthesis, and Research Agenda, Journal of Hospitality Marketing and Management, 29(7): 757-786.
16. Christensen, K. M., Holt, J. M. ve Wilson, J. F. (2013). The Relationship between Outdoor Recreation and Depression among Older Adults, World Leisure Journal, 55(1): 72-82.
17. Colley, K., Currie, M. J. B. ve Irvine, K. N. (2019). Then and Now: Examining Older People's Engagement in Outdoor Recreation Across the Life Course, Leisure Sciences, 41(3): 186-202.
18. Crombie, (2004). Why Older People do not Participate in Leisure Time Physical Activity: A Survey of Activity Levels, Beliefs And Deterrents, Age and Ageing, 33(3): 287-292.
19. Currie, M.; Colley, K. ve Irvine, K. N. (2021). Outdoor Recreation for Older Adults in Scotland: Qualitatively Exploring the Multiplicity of Constraints to Participation, International Journal of Environmental Research Public Health, 18: 7705.
20. Diener, E. (1984). Subjective Well-Being, Psychological Bulletin, 95(3): 542-575.
21. Dünya Sağlık Örgütü (2024). Newsroom. Fact Sheets. Ageing and Health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health, Erişim Tarihi: 04.10.2024
22. Eger, R.J. ve Maridal, J.H. (2015). A Statistical Meta-Analysis of the Wellbeing Literature, International Journal of Wellbeing, 5(2): 123–157.
23. Engelen, L., Rahmann, M. ve de Jong, E. (2022). Design for Healthy Ageing – the Relationship between Design, Well-Being, and Quality of Life: A Review, Building Research and Information, 50(1-2): 19-35.
24. Eronen, J., von Bonsdorff, M., Rantakokko, M. ve Rantanen, T. (2014). Environmental Facilitators for Outdoor Walking and Development of Walking Difficulty in Community-Dwelling Older Adults, European Journal of Ageing, 11: 67-75.
25. Fan, Y., Goh, E., Isa, S. M. ve Yang, S. (2024). 30 Years of Healthy Ageing Research in Tourism and Hospitality: Research Trends and Implications for Future Research, The Service Industries Journal, 1-38.
26. Felce, D. ve Perry, J. (1996). Exploring Current Conceptions of Quality of Life: A Model for People with and without Disabilities. İçinde; R. Renwick, I. Brown ve M. Nagler (Editörler), Quality of life in Health Promotion and Rehabilitation: Conceptual Approaches, Issues, and Applications (ss. 51–62). Londra: Sage Yayınları.
27. Finlay, J., Franke, T., McKay, H. ve Sims-Gould, J. (2015). Therapeutic Landscapes and Wellbeing in Later Life: Impacts of Blue and Green Spaces for Older Adults, Health and Place, 34: 97-106.
28. Focht, B. C. (2009). Brief Walks in Outdoor and Laboratory Environments: Effects on Affective Responses, Enjoyment, and Intentions to Walk for Exercise, Research Quarterly for Exercise and Sport, 80(3): 611-620.
29. Frumkin, H. (2001). Beyond Toxicity: Human Health and the Natural Environment. American Journal of Preventive Medicine, 20(3): 234-240.
30. Gabriel, Z. ve Bowling, A. N. N. (2004). Quality of Life from the Perspectives of Older People, Ageing and Society, 24(5): 675-691.
31. Gagliardi, C., Spazzafumo, L., Marcellini, F., Mollenkopf, H., Ruoppila, I., Tacken, M. ve Szemann, Z. (2007). The Outdoor Mobility and Leisure Activities of Older People in Five European Countries, Ageing and Society, 27(5): 683-700.
32. Garcês, S., Pocinho, M., Jesus, S. N. ve Rieber, M. S. (2018). Positive Psychology and Tourism: A Systematic Literature Review, Tourism and Management Studies, 14(3): 41-51.
33. Gaur, A. ve Kumar, M. (2018). A Systematic Approach to Conducting Review Studies: An Assessment of Content Analysis in 25 Years of IB Research, Journal of World Business, 53(2): 280-289.
34. Gregory, S. F. (2023). Diving with Dignity? Older Women Scuba Divers, Constraints and Accessible Tourism on the Great Barrier Reef, Annals of Leisure Research, 26(5): 716-736.
35. Gregory, S. F. ve Dimmock, K. (2019). Alive and Kicking: the Benefits of Scuba Diving Leisure for Older Australian Women, Annals of Leisure Research, 22(4): 550-574.
36. Hakman, A., Andrieieva, O., Kashuba, V., Dutchak, M., Tomenko, O., Cherednichenko, S. ve Bolshakova, I. (2021). Effect of Recreational Activities in Urban Parks on the Overall Condition of Sedentary Older Adults, Journal of Physical Education and Sport, 21: 2864-2871.
37. Harmon, J. ve Kyle, G. T. (2016) Positive Emotions and Passionate Leisure Involvement, Annals of Leisure Research, 19(1): 62-79.
38. Hickman, M., Stokes, P., Gammon, S., Beard, C. ve Inkster, A. (2018). Moments like Diamonds in Space: Savoring the Ageing Process through Positive Engagement with Adventure Sports, Annals of Leisure Research, 21(5): 612-630.
39. Hu, F., Wen, J., Phau, I., Ying, T., Aston, J. ve Wang, W. (2023). The Role of Tourism in Healthy Aging: An Interdisciplinary Literature Review and Conceptual Model, Journal of Hospitality and Tourism Management, 56: 356-366.
40. Humberstone, B. (2022). Ageing, Agers and Outdoor Recreation: Being Old And Active Outdoors in the Time Of COVID: An Autoethnographic Tale of Different Wor(l)ds.‘I’m not Vulnerable?, Annals of Leisure Research, 25(5): 621-636.
41. Janssen, M. (2004). The Effects of Leisure Education on Quality of Life in Older Adults. Therapeutic Recreation Journal, 38(3): 275-288.
42. Japutra, A., Loureiro, S. M. C., Li, T., Bilro, R. G. ve Han, H. (2022). Luxury Tourism: Where We Go from Now?, Asia Pacific Journal of Tourism Research, 27(8): 871-890.
43. Jeong, E. H. ve Park, J. H. (2020). The Relationship among Leisure Activities, Depression and Quality of Life in Community-Dwelling Elderly Koreans, Gerontology and Geriatric Medicine, 6.
44. Kaba, İ. (2020). Ontolojik İyi-Oluş (Yaşam Projesi), Psikiyatride Güncel Yaklaşımlar, 12(1): 143-154.
45. Kerr, J., Marshall, S., Godbole, S., Neukam, S., Crist, K., Wasilenko, K ve Buchner, D. (2012a). The Relationship between Outdoor Activity and Health in Older Adults using GPS, International Journal of Environmental Research and Public Health, 9(12): 4615-4625.
46. Kerr, J., Sallis, J. F., Saelens, B. E., Cain, K. L., Conway, T. L., Frank, L. D. ve King, A. C. (2012b). Outdoor Physical Activity and Self Rated Health in Older Adults Living in Two Regions of the US, International Journal of Behavioral Nutrition and Physical Activity, 9: 1-4.
47. Kim, H. ve So, K. K. F. (2022). Two Decades of Customer Experience Research in Hospitality and Tourism: A Bibliometric Analysis and Thematic Content Analysis, International Journal of Hospitality Management, 100: 103082.
48. Kim, S., Lee, S., Chun, S., Han, A. ve Heo, J.(2017). The Effects of Leisure-Time Physical Activity for Optimism, Life Satisfaction, Psychological Well-Being, and Positive Affect among Older Adults with Loneliness, Annals of Leisure Research, 20(4): 406-415.
49. King, A. C. (2001). Interventions to Promote Physical Activity by Older Adults, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(suppl_2):36-46.
50. Kuska, M., Nowak, M. A., Żukowska, H., Pasek, M. ve Szark-Eckardt, M. (2023). Intensity of Physical Activity and Quality of Life Among Older Adults, Polish Journal of Sport and Tourism, 30(4): 38-44.
51. Lai, D. W., Ou, X. ve Jin, J. (2022). A Quasi-Experimental Study on The Effect of An Outdoor Physical Activity Program on the Well-Being of Older Chinese People in Hong Kong, International Journal of Environmental Research and Public Health, 19(15): 8950.
52. Lamers, S. M., Westerhof, G. J., Bohlmeijer, E. T., ten Klooster, P. M. ve Keyes, C. L. (2011). Evaluating the Psychometric Properties of the Mental Health Continuum‐Short Form (MHC‐SF), Journal of Clinical Psychology, 67(1): 99-110.
53. Lee-Hauser, C. R., Schein, R. M., Schiappa, V. J., Pruziner, A. L., Tostenrude, D., Goedhard, K. E. ve Schmeler, M. R. (2021). Demographic and Functional Characteristics of National Veterans Wheelchair Games Participants: A Cross-Sectional Study, Military Medicine, 186 (7-8):749-755.
54. Lee, H. ve Heo, S. (2021). Benefits of Leisure Activities for the Quality of Life of Older South Korean Adults, Leisure Studies, 40(2): 199-211.
55. Li, C. L. (2020). Quality of Life: The Perspective of Urban Park Recreation in three Asian Cities, Journal of Outdoor Recreation and Tourism, 29: 100260.
56. MacMillan, F., McBride, K. A., George, E. S. ve Steiner, G. Z. (2019). Conducting a Systematic Review: A Practical Guide. İçinde; P. Liamputtong (Editör), Handbook of Research Methods in Health Social Sciences (ss. 805-826). Singapur: Springer Nature.
57. Michèle, M., Guillaume, M., Alain, T., Nathalie, B., Claude, F. ve Kamel, G. (2019). Social and Leisure Activity Profiles and Well-Being among the Older Adults: A Longitudinal Study, Aging and Mental Health, 23(1): 77-83.
58. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. ve PRISMA Group, T. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement, Annals of Internal Medicine, 151(4): 264-269.
59. Nilsson, G., Ekstam, L. ve Andersson, J. (2018). Pushing for Miracles, Pulling away from Risk: An Ethnographic Analysis of the Force Dynamics at Senior Summer Camps in Sweden, Journal of Aging Studies, 47: 96-103.
60. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D. ve Moher, D. (2021). The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews, BMJ, 372.
61. Papavasileiou, E. F. ve Tzouvanas, P. (2021). Tourism Carbon Kuznets-Curve Hypothesis: A Systematic Literature Review and a Paradigm Shift to a Corporation-Performance Perspective, Journal of Travel Research, 60(4): 896-911.
62. Pedersen, B. K. ve Saltin, B. (2015). Exercise as Medicine - Evidence for Prescribing Exercise As Therapy in 26 Different Chronic Diseases, Scandinavian Journal of Medicine and Science in Sports, 25(S3): 1-72.
63. Petersen, E., Schoen, G., Liedtke, G. ve Zech, A. (2018). Relevance of Urban Green Space for Physical Activity and Health-Related Quality of Life in Older Adults, Quality in Ageing and Older Adults, 19(3): 158-166.
64. Pietilä, M., Neuvonen, M., Borodulin, K., Korpela, K., Sievänen, T. ve Tyrväinen, L. (2015). Relationships between Exposure to Urban Green Spaces, Physical Activity and Self-Rated Health, Journal of Outdoor Recreation and Tourism, 10: 44-54.
65. Rantakokko, M., Keskinen, K. E., Kokko, K. ve Portegijs, E. (2018). Nature Diversity and Well-Being in Old Age, Aging Clinical and Experimental Research, 30: 527-532.
66. Rantanen, T., Äyräväinen, I., Eronen, J., Lyyra, T., Törmäkangas, T., Vaarama, M. ve Rantakokko, M. (2015). The Effect of an Outdoor Activities' Intervention Delivered by Older Volunteers on The Quality of Life of Older People with Severe Mobility Limitations: A Randomized Controlled Trial, Aging Clinical and Experimental Research, 27: 161-169.
67. Richards, D. R., Fung, T. K., Leong, R. A., Sachidhanandam, U., Drillet, Z. ve Edwards, P. J. (2020). Demographic Biases in Engagement with Nature in a Tropical Asian City, Plos One, 15(4): 0231576.
68. Romagosa, F., Eagles, P. F. ve Lemieux, C. J. (2015). From the Inside Out to the Outside in: Exploring the Role of Parks and Protected Areas as Providers of Human Health and Well-Being, Journal of Outdoor Recreation and Tourism, 10: 70-77.
69. Rosalina, P. D., Dupre, K. ve Wang, Y. (2021). Rural Tourism: A Systematic Literature Review on Definitions and Challenges, Journal of Hospitality and Tourism Management, 47: 134-149.
70. Röhr, S., Rodriguez, F. S., Siemensmeyer, R., Müller, F., Romero‐Ortuno, R. ve Riedel‐Heller, S. G. (2022). How Can Urban Environments Support Dementia Risk Reduction? A Qualitative Study, International Journal of Geriatric Psychiatry, 37(1):1-18.
71. Ryan, R. M. ve Deci, E. L. (2000). Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being, American Psychologist, 55(1): 68-78.
72. Ryff, C. D. (1989). Happiness is Everything, or Is It? Explorations on the Meaning of Psychological Well-Being, Journal of Personality and Social Psychology, 57(6), 1069-1081.
73. Ryu, J. ve Heo, J. (2018). Relationships between Leisure Activity Types And Well-Being in Older Adults, Leisure Studies, 37(3): 331-342.
74. Schwartz, G. M. ve Campagna, J. (2008). New Meaning for the Emotional State of the Elderly, from a Leisure Standpoint, Leisure Studies, 27(2): 207-211.
75. Searle, M. S., Mahon, M. J., Iso-Ahola, S. E., Adam, H. ve van Dyck, J. (1995). Enhancing a Sense of Independence and Psychological Well-Being among the Elderly: A Field Experiment, Journal of Leisure Research, 27(2): 107-124.
76. Sefcik, J. S., Hirschman, K. B., Petrovsky, D. V., Hodgson, N. A. ve Naylor, M. D. (2021). Satisfaction with Outdoor Activities among Northeastern US Newly Enrolled Long-Term Services and Supports Recipients, Journal of Applied Gerontology, 40(6): 590-597.
77. Siddaway, A. P., Wood, A. M. ve Hedges, L. V. (2019). How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-Analyses, and Meta-Syntheses, Annual Review of Psychology, 70(1): 747-770.
78. Silverstein, M. ve Parker, M. G. (2002). Leisure Activities and Quality of Life among the Oldest Old in Sweden, Research on Aging, 24(5): 528-547.
79. Sjögren, K. ve Stjernberg, L. (2010). A Gender Perspective on Factors that Influence Outdoor Recreational Physical Activity among The Elderly, BMC Geriatrics, 10: 1-9.
80. Smith, E. S. ve Dalmer, N. K. (2023). Understanding Older Adults’ Participation in Outdoor Adventure Activities: A Scoping Review, Journal of Adventure Education and Outdoor Learning, 1-22.
81. Snyder, H. (2019). Literature Review as a Research Methodology: An Overview and Guidelines, Journal of Business Research, 104: 333-339.
82. Suárez, M., Barton, D. N., Cimburova, Z., Rusch, G. M., Gómez-Baggethun, E. ve Onaindia, M. (2020). Environmental Justice and Outdoor Recreation Opportunities: A Spatially Explicit Assessment in Oslo Metropolitan Area, Norway, Environmental Science and Policy, 108: 133-143.
83. Sugiyama, T. ve Thompson, C. W. (2006). Environmental Support for Outdoor Activities and Older People’s Quality of Life, Journal of Housing for the Elderly, 19(3-4): 167-185.
84. Sugiyama, T. ve Thompson, C. W. (2007). Outdoor Environments, Activity and the Well-Being of Older People: Conceptualising Environmental Support, Environment and Planning A, 39(8): 1943-1960.
85. Szewczenko, A., Lach, E., Bursiewicz, N., Chuchnowska, I., Widzisz-Pronobis, S., Sanigórska, M. ve Ober, J. (2023). Urban Therapy-Urban Health Path as an Innovative Urban Function to Strengthen the Psycho-Physical Condition of the Elderly, International Journal of Environmental Research and Public Health, 20(12): 6081.
86. Thompson Coon, J., Boddy, K., Stein, K., Whear, R., Barton, J. ve Depledge, M. H. (2011). Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review, Environmental Science and Technology, 45(5): 1761-1772.
87. Tohan, M. M., Ahmed, F., Juie, I. J., Kabir, A. ve Rahman, M. A. (2024). Outdoor Recreational Activities and Mental Well-Being of Geriatric People in Bangladesh: Structural Equation Modelling, Discover Psychology, 4(1): 33.
88. Tranfield, D., Denyer, D. ve Smart, P. (2003). Towards a Methodology for Developing Evidence-Informed Management Knowledge by Means of Systematic Review, British Journal of Management, 14(3): 207-222.
89. Wang, W. C. (2022). Relationships between Leisure Involvement and Quality of Life among Users of Public Sports Centre Aged 45 Years and Older, World Leisure Journal, 64(2): 80-195.
90. Ward Thompson, C. W. ve Aspinall, P. A. (2011). Natural Environments and their Impact on Activity, Health, and Quality of Life, Applied Psychology: Health and Well‐Being, 3(3): 230-260.
91. Waterman, A. S. (1993). Two Conceptions of Happiness: Contrasts of Personal Expressiveness (Eudaimonia) and Hedonic Enjoyment, Journal of Personality and Social Psychology, 64: 678-691.
92. Yamashita, T., Bardo, A. R. ve Liu, D. (2019). Experienced Subjective Well-Being during Physically Active and Passive Leisure Time Activities among Adults Aged 65 Years and Older, The Gerontologist, 59(4): 718-726.
93. Yang, E. C. L., Khoo-Lattimore, C. ve Arcodia, C. (2017). A Systematic Literature Review of Risk and Gender Research in Tourism, Tourism Management, 58: 89-100.
94. Yang, Q., Tang, Y., Jennings, G., Zhao, B., Zhu, F. ve Ma, X. (2022). Physical Activity and Subjective Well-Being of Older Adults During COVID-19 Prevention and Control Normalization: Mediating Role of Outdoor Exercise Environment and Regulating Role of Exercise Form, Frontiers in Psychology, 13: 1014967.
95. Yau, M. K. S. ve Packer, T. L. (2002). Health and Well-Being through T ‘ai Chi: Perceptions of Older Adults in Hong Kong, Leisure Studies, 21(2): 163-178.
96. Yen, H. Y.ve Lin, L. J. (2018). Quality of Life in Older Adults: Benefits from the Productive Engagement in Physical Activity, Journal of Exercise Science and Fitness, 16(2): 49-54.
97. Younes, S. R., Marques, B.ve McIntosh, J. (2024). Public Spaces for Older People: A Review of the Relationship between Public Space to Quality of Life, Sustainability, 16(11): 4583.
98. Yuan, K. S. ve Wu, T. J. (2021). Environmental Stressors and Well-Being on Middle-Aged and Elderly People: The Mediating Role of Outdoor Leisure Behaviour and Place Attachment, Environmental Science and Pollution Research, 1-10.
99. Yuan, T., Hong, B., Li, Y., Wang, Y.ve Wang, Y. (2023). The Right Activities at Right Spaces: Relationships between Elderly Adults’ Physical Activities and Thermal Responses, Buildings, 13(3): 721.
100. Yu, S., Liu, Y., Cui, C. ve Xia, B. (2019). Influence of Outdoor Living Environment on Elders’ Quality of Life in Old Residential Communities, Sustainability, 11(23): 6638.
101. Zhou, P., Grady, S. C.ve Rosenberg, M. W. (2023). Creating Therapeutic Spaces for the Public: Elderly Exercisers as Leaders in Urban China, Urban Geography, 44(1): 59-82.
102. Zhu, G. (2024). The Effect of Outdoor Activities on the Medical Expenditure of Older People: Multiple Chain Mediating Effects of Health Benefits, BMC Public Health, 24(1): 1227.
103. Zimmer, Z. ve Lin, H. S. (1996). Leisure Activity and Well-Being among the Elderly in Taiwan: Testing Hypotheses in an Asian Setting, Journal of Cross-Cultural Gerontology, 11(2): 167-186.
104. Zingmark, M., Ankre, R. ve Wall-Reinius, S. (2021). Promoting Outdoor Recreation among Older Adults in Sweden–A Theoretical and Empirical Foundation for the Development of an Intervention, Archives of Public Health, 79: 1-15.
105. Zurawik, M. (2020). Moving through Spaces–Leisure Walking and Its Psychosocial Benefits for Well-Being: A Narrative Review, Human Movement, 21(2): 1-8.