Physical Environmental Hazards and Major Depression in Older U.S. Adults: The Health and Retirement Study

Abstract

Background and Aim. Major depression is a leading cause of disability. Although much research focuses on individual risk factors and interventions, environmental risk factors may also play an important role in major depression. We quantified associations of road noise and light at night with prevalent major depression. Methods. We used data from the 2008-2016 biennial interviews of the Health and Retirement Study, a nationally-representative cohort of older adults in the United States. Major depression status was determined using the Composite International Diagnostic Interview Short Form, with a cutoff of ≥5. We estimated average road noise and light at night for the year prior to each interview at participant residences using the Department of Transportation Road Noise Model and satellite imagery from the Defense Meteorological Satellite Program, respectively. To estimate prevalence ratios, we used a modified Poisson regression model that accounted for sampling weights and design effects, adjusted for demographic characteristics, individual and neighborhood SES, time, co-exposures, and geographic area. Results. There were 23,874 participants with complete data. The mean baseline age was 63 years, 53% were female, 74% were Non-Hispanic White, and 15% ever reported major depression. Compared to the lowest exposure quartiles, those in the highest quartiles of noise and light exposure were more likely to be Black, have less than a high school education and reside in an urban area. In fully adjusted models, interquartile differences in both noise and light were suggestively associated with an approximately 10% greater prevalence of major depression (PR per IQR of noise: 1.08, 95% CI: 0.98, 1.20; and light: 1.12, 95%CI: 0.96, 1.31). Conclusion. Exposure to noise and light at night may increase depression in older adults, possibly by disrupting health sleep. Modifying physical hazards in the environment may be a way to reduce the burden of depression. Keywords. Noise, Light, Depression