Shiyu Lu1, Yuqi Liu2, Yingqi Guo2, Hung Chak Ho3,4, Yimeng Song5, Wei Cheng3, Cheryl Chui2, On Fung Chan1, Chris Webster6,7, Rebecca L H Chiu3,4, Terry Y Lum1,2. 1. Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong, China. 2. Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong, China. 3. Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong, China. 4. Centre of Urban Studies and Urban Planning, The University of Hong Kong, Pok Fu Lam, Hong Kong, China. 5. Smart Cities Research Institute, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China. 6. Faculty of Architecture, The University of Hong Kong, Pok Fu Lam, Hong Kong, China. 7. Healthy High Density Cities Lab, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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.