Zhang Jingya, Dai Chen, Wang Qing, Zhao Wenzheng, Shen Guodong, Cheng Jing, Chen Ren, Zhang Yan
Department of Health Service Management, School of Health Service Management, Anhui Medical University, 81-Meishan Road, Hefei, Anhui, 230032, P. R. China.
Anhui Province Key Laboratory of Geriatric Immunology and Nutrition Therapy, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, P.R. China.
BMC Public Health. 2025 Feb 13;25(1):603. doi: 10.1186/s12889-025-21870-w.
This study aims to investigate the relationships between living and neighborhood environmental factors and anxiety symptoms among older adults residing in urban and rural areas of Anhui Province, China.
Data were collected from 5876 participants in a cross-sectional study carried out in four cities located in Anhui, China. Anxiety symptoms were evaluated via the Generalized Anxiety Disorder scale (GAD-7), and participants with scores of 5 and above were defined as having anxiety symptoms. The presence of dust and noise in the context of daily life was used to evaluate the living environment of the participants. The neighborhood environment was assessed by the availability of barrier-free facilities, proximity to facilities (supermarkets, restaurants, hospitals, and parks), and green and blue space near participants' dwellings. Multilevel linear and logistic regression analyses were used to estimate the associations between these environmental factors and anxiety symptoms.
The participants who lived in dusty environments had elevated GAD-7 scores and higher odds of anxiety (dust: β = 0.754, 95% CI: 0.337, 1.171; OR = 1.451, 95% CI: 1.164, 1.809). Having barrier-free facilities and the existence of a neighboring park decreased the GAD-7 scores and the likelihood of having anxiety symptoms (barrier-free facilities: β=-0.503, 95% CI: -0.992, -0.085; OR = 0.768, 95% CI: 0.656, 0.899; park: β=-0.478, 95% CI: -0.830, -0.125; OR = 0.599, 95% CI: 0.440, 0.816). However, participants residing in close proximity to the hospital presented an increased likelihood of experiencing anxiety symptoms (OR = 1.377, 95% CI: 1.162, 1.631).
Participants who lived in dusty and noisy environments were more likely to suffer from anxiety, whereas those who lived near barrier-free facilities and parks were at lower risk. The findings emphasize the need for targeted interventions to create age-friendly communities, suggesting an integrated approach that combines environmental health strategies with mental health strategies for older adults.
本研究旨在调查中国安徽省城乡地区老年人的生活及邻里环境因素与焦虑症状之间的关系。
数据来自在中国安徽省四个城市开展的一项横断面研究中的5876名参与者。通过广泛性焦虑障碍量表（GAD-7）评估焦虑症状，得分在5分及以上的参与者被定义为有焦虑症状。用日常生活中的灰尘和噪音情况来评估参与者的生活环境。通过无障碍设施的可用性、与设施（超市、餐馆、医院和公园）的距离以及参与者住所附近的绿色和蓝色空间来评估邻里环境。采用多水平线性和逻辑回归分析来估计这些环境因素与焦虑症状之间的关联。
生活在多尘环境中的参与者GAD-7得分升高，焦虑几率更高（灰尘：β = 0.754，95%可信区间：0.337，1.171；比值比 = 1.451，95%可信区间：1.164，1.809）。有无障碍设施和附近有公园会降低GAD-7得分以及出现焦虑症状的可能性（无障碍设施：β = -0.503，95%可信区间：-0.992，-0.085；比值比 = 0.768，95%可信区间：0.656，0.899；公园：β = -0.478，95%可信区间：-0.830，-0.125；比值比 = 0.599，95%可信区间：0.440，0.816）。然而，居住在医院附近的参与者出现焦虑症状的可能性增加（比值比 = 1.377，95%可信区间：1.162，1.631）。
生活在多尘和嘈杂环境中的参与者更容易患焦虑症，而生活在无障碍设施和公园附近的人风险较低。研究结果强调了有针对性地进行干预以创建对老年人友好型社区的必要性，建议采用一种将环境健康策略与老年人心理健康策略相结合的综合方法。
