Association of neighbourhood social and physical attributes with depression in older adults in Hong Kong: A multilevel analysis

Background Previous studies investigating the independent effects of neighbourhood-level factors on depression are rare within the Asian context, especially in the elderly population. Methods Data for 29 099 older adults aged 65 years or above who have received health examinations at elderly health centres in Hong Kong in 2008-2011 were analysed. Using multilevel regression modelling, the cross-sectional associations of neighbourhood social attributes (neighbourhood poverty, ethnic minority, residential stability and elderly concentration) and physical (built) attributes (recreational services and walkability) with depression outcomes (depressive symptoms and depression) after adjusting for individual-level characteristics were investigated. Gender interaction effects were also examined. Results Neighbourhood poverty was associated with both depressive symptoms and depression in the elderly. Neighbourhood elderly concentration, recreational services and walkability were associated with fewer depressive symptoms. The association between neighbourhood poverty and elderly depressive symptoms was found in women only and not in men. Conclusion Policies aimed at reducing neighbourhood poverty, increasing access to recreational services and enhancing walkability might be effective strategies to prevent depression in older adults in the urban settings.