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一项关于欧洲老年成年人邻里环境与抑郁症的纵向研究:这些关联是否因童年应激源暴露情况而异?

A longitudinal study of neighbourhood conditions and depression in ageing European adults: Do the associations vary by exposure to childhood stressors?

作者信息

Baranyi Gergő, Sieber Stefan, Pearce Jamie, Cheval Boris, Dibben Chris, Kliegel Matthias, Cullati Stéphane

机构信息

Centre for Research on Environment Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom.

Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Switzerland.

出版信息

Prev Med. 2019 Sep;126:105764. doi: 10.1016/j.ypmed.2019.105764. Epub 2019 Jun 30.

Abstract

Emerging literature emphasises the association between neighbourhood conditions and late life depression. Childhood experiences, crucial for life course development of mental health, may modify how neighbourhood affects subsequent depression. This study assessed the longitudinal associations of access to services and neighbourhood nuisance with depression among older adults, and tested whether these associations varied by exposure to childhood stressors. Data were drawn from the cross-national Survey of Health, Ageing and Retirement in Europe, a prospective cohort study between 2004/2005 and 2015, representative for European adults over the age of 50. Individual perceptions of neighbourhood were measured at baseline; childhood stressors, defined as socioeconomic conditions, adverse experiences and health problems, were collected retrospectively. Multilevel logistic regression estimated the risk of depression (n = 10,328). Access to services were negatively (OR = 0.78, 95% CI 0.68-0.90) and neighbourhood nuisance positively (OR = 1.36, 95% CI 1.18-1.56) associated with the probability of depression during follow-up. We found interactions between neighbourhood and childhood socioeconomic conditions, but not with adverse experiences and health problems. While older adults who grew up in better childhood socioeconomic conditions benefited more from living in a residential area with good access to services, they were at higher risk of developing depression when residing in areas with more neighbourhood nuisances. Older adults' mental health can benefit from better access to public transportation and neighbourhood amenities, while physical and social problems in the local area increase the risk of depression. Importantly, socioeconomic circumstances in early life may influence vulnerability to neighbourhood effects in older age.

摘要

新出现的文献强调了社区环境与晚年抑郁症之间的关联。童年经历对心理健康的生命历程发展至关重要,可能会改变社区环境对后续抑郁症的影响方式。本研究评估了老年人获得服务的机会和社区滋扰与抑郁症之间的纵向关联,并测试了这些关联是否因童年应激源的暴露情况而异。数据来自欧洲健康、老龄化和退休调查这一跨国研究,这是一项在2004/2005年至2015年期间进行的前瞻性队列研究,代表了50岁以上的欧洲成年人。在基线时测量了个人对社区的看法;童年应激源被定义为社会经济状况、不良经历和健康问题,通过回顾性收集。多水平逻辑回归估计了抑郁症的风险(n = 10328)。获得服务的机会与随访期间患抑郁症的概率呈负相关(OR = 0.78,95%CI 0.68 - 0.90),而社区滋扰与患抑郁症的概率呈正相关(OR = 1.36,95%CI 1.18 - 1.56)。我们发现社区环境与童年社会经济状况之间存在相互作用,但与不良经历和健康问题之间不存在相互作用。虽然在童年社会经济状况较好的环境中长大的老年人,从居住在服务设施便利的居民区中受益更多,但当他们居住在社区滋扰较多的地区时,患抑郁症的风险更高。老年人的心理健康可以从更好地获得公共交通和社区便利设施中受益,而当地的身体和社会问题会增加患抑郁症的风险。重要的是,早年的社会经济状况可能会影响老年人对社区环境影响的易感性。

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