Neighbourhood Amenities and Depressive Symptoms in Urban-Dwelling Older Adults

Shahirah Gillespie, Michael Levasseur, Yvonne Michael
2017 Journal of Urban Design and Mental Health   unpublished
OF PRACTICAL IMPLICATIONS The current findings support public policy to promote neighbourhoods with dynamic and diverse amenities to maintain the mental health and reduce the prevalence of depression in older adults. This is particularly important for older adults with optimal mobility. Further, interventions should be devised that increase mobility and life space among older adults. Abstract Adults living in poorer neighbourhoods are at increased risk of developing depression, possibly as a
more » ... n, possibly as a result of disproportionate exposure to stressors and limited access to beneficial resources in the immediate neighbourhood. The aims of this paper were to assess the association between amenity diversity in urban neighbourhoods and depression in older adults, and to evaluate how this effect was modified by older adult mobility. This cross-sectional study used data from a random digit dial sample of community-dwelling older adults in Philadelphia, PA (age range: 65-98, n=658). Amenity diversity was assessed using the Leadership in Energy and Environmental Design Neighbourhood Development (LEED-ND) index for participants' neighbourhoods (census tracts = 276). Mobility was assessed using the Life-Space Assessment (LSA), which quantified the distance and frequency individuals moved past their bedroom and home within the past month. Depressive symptoms were measured using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D); those with 4 or more symptoms were categorised as having symptoms of depression. We found a population prevalence of depression of 14%. Mobility significantly modified association between amenity, diversity and depression. After adjustment for factors such as: age, sex, education, marital status, race/ethnicity, smoking, and income among high mobility older adults living in low amenity and moderate amenity neighbourhoods were more likely to have symptoms of depression compared to people living in high neighbourhood amenity neighbourhoods (Odds ratio, 95% confidence interval: 5.75,
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