Exploring the role of built environments and depressive symptoms in community-dwelling older adults: A case of Taiwan

Abstract

Objectives

Depression in older adults is a growing public health concern. However, limited research has focused on the issues of physical environments and depression in the elderly in Asia. The purpose of the study is to examine the relationship between the built environments and depressive symptoms in older adults using Taiwan as an example.

Methods

Two national datasets were used in this study, including the 2009 National Health Interview Survey and the 2006 National Land Use Investigation in Taiwan. A total of 2,155 older adults were recruited, and eight built environments were examined among 161 townships. Depressive symptoms were measured using a 10-item CES-D scale, and four sophisticated models were built using a multi-level analysis.

Results

Five types of built environments were found to be significantly associated with depressive symptoms in older adults. Among them, two types of built environments, ‘health and medical services’ and ‘schools’ were highly related to a lower CES-D score and lower odds of being depressed, whereas the other three built environments, ‘cultural and historical facilities,’ ‘recreational and amusement areas,’ and ‘playgrounds and sports venues’ were significantly associated with an increasing risk of being depressed.

Conclusions

Different built environments had different effects on depression and some even showed a dose-response relationship. These results can help urban planners or city designers reconsider how to facilitate the construction of built environments in neighborhoods that will improve the mental health of older adults.

Keywords:

• Built environments
• depressive symptoms
• older adults
• multilevel analysis

Acknowledgements

We are grateful to the Health Data Science Center, National Cheng Kung University Hospital for providing administrative and technical support. We also express our appreciation for the suggestions from the research committee members in National Cheng Kung University.

Disclosure statement

No conflict of interest was reported by the author(s).

Author contributions

Nuan-Ching Huang conducted the study, analyzed the data, and wrote the daft. Shiann-Far Kung advised the study and revised the draft. Susan C. Hu designed and organized the study, and completed the manuscript. All authors contributed to the interpretation of results, critically reviewed the draft, and approved the final manuscript.

Compliance with ethical standards

All procedures performed in this study were in accordance with the ethical standards of Institutional Review Board, National Cheng Kung University Hospital, by Human Study Approval (IRB No: B-ER-104-087).

Additional information

Funding

This study was supported by the Ministry of Science and Technology, Taiwan (grant no.: MOST 107-2635-B-006-002) and the Health Promotion Administration, Ministry of Health and Welfare, Taiwan (grant no.: MOHW107-HPA-M-114-144703).