The built environment and depression in later life: The health in men study

Abstract

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. © 2011 American Association for Geriatric Psychiatry.