The built environment and depression in later life: the health in men study.
OBJECTIVE
This study examined the impact of built environment (BE) attributes on depression in older men to determine whether associations were independent of neighborhood composition factors and sociodemographic, psychosocial, and health factors at the individual level.


METHODS
The authors used geocoded data from the Health in Men Study collected in Western Australia in 2001 (N = 5,218). Depression was measured using the self-rated 15-item Geriatric Depression Scale. Geographic Information Systems were used to objectively measure BE attributes. Univariate logistic regressions were applied to select relevant covariates. Multivariate logistic regressions were conducted to examine BE attributes both separately and conjointly.


RESULTS
Higher degrees of land-use mix were associated with higher odds of depression independent of other factors, including street connectivity and residential density (odds ratio = 1.54, 95% confidence interval [CI] = 1.10-2.16, and odds ratio = 1.52, 95% CI = 1.08-2.14 for the second and third tertiles, respectively). Further examination showed that retail availability was associated with a 40% increase in the odds of depression (95% CI = 4%-90%) independent of other factors, including availability of other land uses.


CONCLUSIONS
The BE is independently associated with depression through land-use mix, and specifically through retail availability. Although local retail facilitates walking, our findings suggest that it may increase the odds of depression in older men. This requires further exploration but suggests the need for careful planning of retail in residential environments, particularly near housing for older adults.
Saarloos
Dick
D
Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, Australia.
Alfonso
Helman
H
Giles-Corti
Billie
B
Middleton
Nick
N
Almeida
Osvaldo P
OP
D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D019964:Mood Disorders / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000517:prevention & control; D016138:Walking; D014904:Western Australia / Q000453:epidemiology