Cross-sectional associations of objectively-assessed neighbourhood attributes with depressive symptoms in older adults of an ultra-dense urban environment: The Hong Kong ALECS study
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AbstractObjectives
This study aimed to examine the associations between objectively assessed neighbourhood environmental attributes and depressive symptoms in Hong Kong Chinese older adults and the moderating effects of neighbourhood environmental attributes on the associations between living arrangements and depressive symptoms.

Design
Cross-sectional observational study.

Setting
Hong Kong.

Participants
909 Hong Kong Chinese community dwellers aged 65+ years residing in preselected areas stratified by walkability and socioeconomic status.

Exposure and outcome measures
Attributes of participants' neighbourhood environment were objectively assessed using geographic information systems and environmental audits. Depressive symptoms were measured using the Geriatric Depression Scale.

Results
Overall, pedestrian infrastructure (OR=1.025; P=0.008), connectivity (OR=1.039; P=0.002) and prevalence of public transport stops (OR=1.056; P=0.012) were positively associated with the odds of reporting depressive symptoms. Older adults living alone were at higher risk of reporting any depressive symptoms than those living with others (OR=1.497; P=0.039). This association was moderated by neighbourhood crowdedness, perceptible pollution, access to destinations and presence of people. Residing in neighbourhoods with lower levels of these attributes was associated with increased deleterious effects of living alone. Living 'n neighbourhoods with lower public transport density also increased the deleterious effects of living alone on the number of depressive symptoms. Those living alone and residing in neighbourhoods with higher levels of connectivity tended to report more depressive symptoms than their counterparts.

Conclusions
The level of access to destinations and social networks across Hong Kong may be sufficiently high to reduce the risk of depressive symptoms in older adults. Yet, exposure to extreme levels of public transport density and associated traffic volumes may increase the risk of depressive symptoms. The provision of good access to a variety of destinations, public transport and public open spaces for socialising in the neighbourhood may help reduce the risk of depressive symptoms in older adults who live alone.
Acceptance Date27/02/2018
All Author(s) ListZhang C.J.P., Barnett A., Sit C.H.P., Lai P.C., Johnston J.M., Lee R.S.Y., Cerin E.
Journal nameBMJ Open
Year2018
Month3
Volume Number8
Issue Number3
PublisherBMJ PUBLISHING GROUP
Article numbere020480
ISSN2044-6055
LanguagesEnglish-United States

Last updated on 2021-17-06 at 00:23