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Relationships between the neighborhood environment and depression in older adults: a systematic review and meta-analysis

Published online by Cambridge University Press:  10 December 2017

Anthony Barnett ,
Casper J. P. Zhang ,
Janice M. Johnston  and
Ester Cerin
Anthony Barnett*
Affiliation:
Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria, 3066, Australia
Casper J. P. Zhang
Affiliation:
School of Public Health, The University of Hong Kong, Hong Kong, China
Janice M. Johnston
Affiliation:
School of Public Health, The University of Hong Kong, Hong Kong, China
Ester Cerin
Affiliation:
Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria, 3066, Australia
*
Correspondence should be addressed to: Anthony Barnett, Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, Victoria 3066, Australia. Phone: +61 3 9230 8261. Email: Anthony.Barnett@acu.edu.au.
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Abstract

Background:

While depression is a growing public health issue, the percentage of individuals with depression receiving treatment is low. Physical and social attributes of the neighborhood may influence the level of depressive symptoms and the prevalence of depression in older adults.

Methods:

This review systematically examined the literature on neighborhood environmental correlates of depression in older adults. Findings were analyzed according to three depression outcomes: depressive symptoms, possible depression, and clinical depression. Based on their description in the article, environmental variables were assigned to one of 25 categories. The strength of evidence was statistically quantified using a meta-analytical approach with articles weighted for sample size and study quality. Findings were summarized by the number of positive, negative, and statistically non-significant associations by each combination of environmental attribute – depression outcome and by combining all depression outcomes.

Results:

Seventy-three articles met the selection criteria. For all depression outcomes combined, 12 of the 25 environmental attribute categories were considered to be sufficiently studied. Three of these, neighborhood socio-economic status, collective efficacy, and personal/crime-related safety were negatively associated with all depression outcomes combined. Moderating effects on associations were sparsely investigated, with 52 articles not examining any. Attributes of the physical neighborhood environment have been understudied.

Conclusion:

This review provides support for the potential influence of some neighborhood attributes on population levels of depression. However, further research is needed to adequately examine physical attributes associated with depression and moderators of both social and physical neighborhood environment attribute – depression outcome associations.

Keywords

active lifestylemental healthphysical environmentsocial environmentsocio-ecological models
Type
Review Article
Information
International Psychogeriatrics , Volume 30 , Issue 8: Issue Theme: Caregiver Stress , August 2018 , pp. 1153 - 1176
Copyright
Copyright © International Psychogeriatric Association 2017 

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Footnotes

#

The authors contributed equally to this work.

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