title: Protective association between neighborhood walkability and depression in older men.
abstract: OBJECTIVE
  To evaluate the association between neighborhood walkability and depression in older adults.
  
  
  METHODS
  Cross-sectional analysis using data from Adult Changes in Thought (ACT), a prospective, longitudinal cohort study.
  
  
  METHODS
  King County, Washington.
  
  
  METHODS
  Seven hundred forty randomly selected men and women aged 65 and older, cognitively intact, living in the same home for at least 2 years.
  
  
  METHODS
  Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. The Walkable and Bikable Communities Project provided objective data predicting the probability of walking at least 150 minutes per week in a particular neighborhood. ACT data were linked at the individual level via a geographic information system to this walkability score using buffer radii of 100, 500, and 1,000 meters around the subject's home. Multiple regression analysis tests were conducted for associations between the buffer-specific neighborhood walkability score and depressive symptoms.
  
  
  RESULTS
  There was a significant association between neighborhood walkability and depressive symptoms in men when adjusted for individual-level factors of income, physical activity, education, smoking status, living alone, age, ethnicity, and chronic disease. The odds ratio for the interquartile range (25th to 75th percentile) of walkability score was 0.31 to 0.33 for the buffer radii (P=.02), indicating a protective association with neighborhood walkability. This association was not significant in women.
  
  
  CONCLUSIONS
  This study demonstrates a significant association between neighborhood walkability and depressive symptoms in older men. Further research on the effects of neighborhood walkability may inform community-level mental health treatment and focus depression screening in less-walkable areas.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA. Ethan.M.Berke@dartmouth.edu
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Berke
authors.forename: Laura M
authors.initials: LM
authors.lastname: Gottlieb
authors.forename: Anne Vernez
authors.initials: AV
authors.lastname: Moudon
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012111:Residence Characteristics; D012737:Sex Factors; D012923:Social Class; D016138:Walking; D014861:Washington / Q000453:epidemiology