Beard John R, Cerdá Magda, Blaney Shannon, Ahern Jennifer, Vlahov David, Galea Sandro
Center for Urban Epidemiological Studies, New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029-5202, USA.
Am J Public Health. 2009 Jul;99(7):1308-14. doi: 10.2105/AJPH.2007.125104. Epub 2008 Nov 13.
We investigated the relationship between the depressive symptoms of older adults over time and the characteristics of the neighborhoods in which they live.
We surveyed a random sample of 1325 New York City residents aged 50 years or older in 2005 and conducted 808 follow-up interviews in 2007. We assessed the compositional characteristics of the respondents' neighborhoods at a census-tract level and determined the relationships between these characteristics and changes in respondents' depressive symptoms.
In multivariable models that adjusted for individual-level covariates including income, a range of neighborhood characteristics predicted worsening depressive symptoms. Factor analysis suggested that these characteristics operated in 3 clusters: neighborhood socioeconomic influences, residential stability, and racial/ethnic composition, with positive neighborhood socioeconomic influences being significantly protective against worsening symptoms. Life stressors, personality trait neuroticism, African American race, and daily baseline contact with social networks were also associated with worsening symptoms.
An older adult's neighborhood of residence is an important determinant of his or her mental health. Those making efforts to improve mental health among the elderly need to consider the role of residential context in improving or impairing mental health.
我们调查了老年人抑郁症状随时间的变化情况及其居住社区特征之间的关系。
2005年,我们对1325名年龄在50岁及以上的纽约市居民进行了随机抽样调查,并于2007年进行了808次随访访谈。我们在普查区层面评估了受访者社区的构成特征,并确定了这些特征与受访者抑郁症状变化之间的关系。
在对包括收入在内的个体层面协变量进行调整的多变量模型中,一系列社区特征预示着抑郁症状会加重。因子分析表明,这些特征可分为3类:社区社会经济影响、居住稳定性和种族/民族构成,其中积极的社区社会经济影响对症状加重具有显著的保护作用。生活压力源、人格特质神经质、非裔美国人种族以及与社交网络的日常基线接触也与症状加重有关。
老年人的居住社区是其心理健康的重要决定因素。那些致力于改善老年人心理健康的人需要考虑居住环境在改善或损害心理健康方面所起的作用。