Lu Shiyu, Liu Yuqi, Guo Yingqi, Ho Hung Chak, Song Yimeng, Cheng Wei, Chui Cheryl, Chan On Fung, Webster Chris, Chiu Rebecca L H, Lum Terry Y
Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
J Gerontol B Psychol Sci Soc Sci. 2021 Nov 15;76(10):2143-2154. doi: 10.1093/geronb/gbab037.
Neighborhood built environments (BEs) are increasingly recognized as being associated with late-life depression. However, their pathways are still understudied. This study investigates the mediating effects of physical and social activities (PA and SA) and functional ability (FA) in the relationships between BEs and late-life depression.
We conducted a cross-sectional analysis with data from 2,081 community-dwellers aged 65 years and older in Hong Kong in 2014. Two road-network-based service area buffers (200- and 500-m buffers) adjusted by terrain and slope from participants' residences were created to define the scope of neighborhoods. BEs comprised population density in District Council Constituency Areas, urban greenness, land-use diversity, and neighborhood facilities within 200- and 500-m buffers. Multilevel path analysis models were used.
More urban greenness within both buffers and more commercial facilities within a 500-m buffer were directly associated with fewer depressive symptoms. SA mediated the relationship between the number of community facilities and depressive symptoms within a 200-m buffer. Neighborhood urban greenness and the number of commercial facilities had indirect associations on depressive symptoms within a 500-m buffer, which were mediated by FA.
Our findings have implications for the ecological model of aging. The mediating effects of SA and FA underscore the importance of promoting active social lifestyles and maintaining FA for older adults' mental health in high-density cities. Policy implications on how to build age-friendly communities are discussed.
邻里建成环境（BEs）越来越被认为与晚年抑郁症有关。然而，其作用途径仍未得到充分研究。本研究调查了身体和社交活动（PA和SA）以及功能能力（FA）在BEs与晚年抑郁症关系中的中介作用。
我们对2014年香港2081名65岁及以上社区居民的数据进行了横断面分析。根据参与者住所的地形和坡度调整创建了两个基于道路网络的服务区缓冲区（200米和500米缓冲区），以界定邻里范围。BEs包括区议会选区的人口密度、城市绿化、土地利用多样性以及200米和500米缓冲区内的邻里设施。使用了多层次路径分析模型。
两个缓冲区内更多的城市绿化以及500米缓冲区内更多的商业设施与更少的抑郁症状直接相关。SA介导了200米缓冲区内社区设施数量与抑郁症状之间的关系。邻里城市绿化和商业设施数量在500米缓冲区内对抑郁症状有间接关联，其由FA介导。
我们的研究结果对衰老的生态模型有启示。SA和FA的中介作用强调了在高密度城市中促进积极的社会生活方式和维持FA对老年人心理健康的重要性。讨论了关于如何建设适合老年人居住社区的政策含义。
