Neighborhood Built Environment and Late-Life Depression: A Multilevel Path Analysis in a Chinese Society

Author:

Lu Shiyu1ORCID,Liu Yuqi2,Guo Yingqi2,Ho Hung Chak34,Song Yimeng5ORCID,Cheng Wei3,Chui Cheryl2ORCID,Chan On Fung1,Webster Chris67,Chiu Rebecca L H34,Lum Terry Y12

Affiliation:

1. Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

2. Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

3. Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

4. Centre of Urban Studies and Urban Planning, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

5. Smart Cities Research Institute, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China

6. Faculty of Architecture, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

7. Healthy High Density Cities Lab, The University of Hong Kong, Pok Fu Lam, Hong Kong, China

Abstract

Abstract Objectives Neighborhood built environments (BEs) are increasingly recognized as being associated with late-life depression. However, their pathways are still understudied. This study investigates the mediating effects of physical and social activities (PA and SA) and functional ability (FA) in the relationships between BEs and late-life depression. Methods We conducted a cross-sectional analysis with data from 2,081 community-dwellers aged 65 years and older in Hong Kong in 2014. Two road-network-based service area buffers (200- and 500-m buffers) adjusted by terrain and slope from participants’ residences were created to define the scope of neighborhoods. BEs comprised population density in District Council Constituency Areas, urban greenness, land-use diversity, and neighborhood facilities within 200- and 500-m buffers. Multilevel path analysis models were used. Results More urban greenness within both buffers and more commercial facilities within a 500-m buffer were directly associated with fewer depressive symptoms. SA mediated the relationship between the number of community facilities and depressive symptoms within a 200-m buffer. Neighborhood urban greenness and the number of commercial facilities had indirect associations on depressive symptoms within a 500-m buffer, which were mediated by FA. Discussion Our findings have implications for the ecological model of aging. The mediating effects of SA and FA underscore the importance of promoting active social lifestyles and maintaining FA for older adults’ mental health in high-density cities. Policy implications on how to build age-friendly communities are discussed.

Funder

Hong Kong Housing Society

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Gerontology,Clinical Psychology,Social Psychology

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