Public Health Department, Universidad del Norte, Barranquilla, Atlántico, Colombia.
Public Health Department, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia.
PLoS One. 2019 Jul 10;14(7):e0219540. doi: 10.1371/journal.pone.0219540. eCollection 2019.
A growing body of literature shows that neighborhood characteristics influence older adults' mental health. Therefore, the aim of this study was to examine the association between structural and social characteristics of the neighborhood, and depression in Mexican older adults. A longitudinal study was conducted based on waves 1 (2009-2010) and 2 (2014) of the Mexican sample from the Study on global AGEing and adult health (SAGE). A street-network buffer around each participant's household was used to define neighborhood, so that built environment and social characteristics were assessed within it. Depression was ascertained by using an algorithm based on the Composite International Diagnostic Interview. In the analysis, multilevel logistic regression models were constructed separately for each built and social environments measurement, adjusted for socioeconomic, demographic and health-related covariates, and stratified by area of residence (urban versus rural). The results showed that a length of space between 15-45 meters restricted to vehicles was significantly associated with a lower risk of depression in older adults from the urban area (OR: 0.44; IC 95% 0.23-0.83) and the protective association appeared to be larger with increasing space with this restriction, although it lacked significance. Contrarily, the built environment measures were not predictive of depression in the rural setting. On the other hand, none of the variables from the social environment had a significant association, although safety appeared to behave as a risk factor in the overall (OR: 1.48; CI 95% 0.96-2.30; p = 0.08) and rural (OR: 3.44; CI 95% 0.95-12.45; p = 0.06) samples, as it reached marginal significance. Research about neighborhood effects on older adults' mental health is an emergent field that has shown that depression might be treated not only from the individual-level, but also from the neighborhood-level. Additionally, further research is needed, especially in low- and middle-income countries, to help guide neighborhood policies.
越来越多的文献表明，邻里特征会影响老年人的心理健康。因此，本研究旨在探讨邻里的结构和社会特征与墨西哥老年人抑郁之间的关系。这项纵向研究基于墨西哥样本在全球老龄化和成人健康研究（SAGE）中的第 1 波（2009-2010 年）和第 2 波（2014 年）的数据。使用每个参与者家庭周围的街道网络缓冲区来定义邻里，以便在其中评估建成环境和社会特征。使用基于综合国际诊断访谈的算法来确定抑郁情况。在分析中，分别针对每个建成环境和社会环境测量值构建了多层次逻辑回归模型，调整了社会经济、人口统计学和健康相关的协变量，并按居住区域（城市与农村）进行分层。结果表明，车辆限制在 15-45 米之间的空间长度与城市地区老年人患抑郁症的风险降低显著相关（OR：0.44；95%CI 0.23-0.83），而且这种限制下的空间越大，保护作用似乎越大，尽管这没有统计学意义。相反，建成环境测量值并不能预测农村地区的抑郁情况。另一方面，社会环境中的变量均与抑郁无显著关联，尽管安全状况似乎是总体（OR：1.48；95%CI 0.96-2.30；p = 0.08）和农村（OR：3.44；95%CI 0.95-12.45；p = 0.06）样本中的一个风险因素，尽管这仅达到边缘显著水平。关于邻里对老年人心理健康影响的研究是一个新兴领域，该领域表明，抑郁不仅可以从个体层面进行治疗，也可以从邻里层面进行治疗。此外，还需要进一步的研究，特别是在中低收入国家，以帮助指导邻里政策。
