Neighbourhood Amenities and Depressive Symptoms in Urban-Dwelling Older Adults

Adults living in poorer neighbourhoods are at increased risk of developing depression, possibly as a result of Journal of Urban Design and Mental Health 2017;2:4 TABLE OF CONTENTS * Corresponding author: ylm23@drexel.edu Objective: H OME ABOUT BLOG J OURN AL E VE N T S VID E OS PUBL ICAT ION S MORE . PDF generated automatically by the HTML to PDF API of PDFmyURL 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, 1.14 – 28.91, 3.93, 0.80-19.19, respectively). Neighbourhood amenity diversity was not associated with depression among low mobility older adults. The findings support public policy to promote neighbourhoods with diverse amenities as a means to support mental health in older adults. Introduction Depression is the most common form of mental illness and its prevalence is projected to increase (CDC, 2013a). Older adults are at an increased risk for developing depression, as they are more prone to chronic health complications and mobility restrictions, which act as stressors and have the potential to destabilise their mental health (CDC, 2013b). Despite the importance of understanding risk factors for depression in older adults, they are generally left out of studies on mental health (Aneshensel et al., 2007; Cairney & Krause, 2004; Fiske, Wetherell, & Gatz, 2009; Galea et al., 2007). Neighbourhood factors may be important independent contributors to the etiology of depression (Kim, 2008; Mair et al., 2008). Research consistently demonstrates an inverse relationship between mental health and individual, as well as neighbourhood-level socioeconomic status (Back & Lee, 2011; Galea et al., 2007; Kim, 2008). The ‘differential vulnerability’ theory suggests that adults living Methods: