Urban design and Japanese older adults' depressive symptoms

Abstract

Despite associations found between physical activity and depression, and the built environment and physical activity, there appears to be inconclusive evidence regarding the role of built environment attributes with preventing depression among the elderly. This is mainly because few studies exist on this topic. In addition, the majority of existing studies have been conducted in Western countries; and there is a dearth of studies in other regions, where the built, social, and cultural environment is different than Western countries. Using data from Japanese older adults, this study examined the associations between objectively-assessed built environment attributes and depressive symptoms. We examined these associations stratified by gender, since research has well-documented gender differences in depression. Data were from 328 older adults living in Japan. Built environment attributes were objectively calculated and Walk Score® ratings were obtained from the website. Depressive symptoms were assessed using the GDS-15. Gender-stratified regression models were used to estimate the associations. We found that a walkable environment characterized by a high population density and proximate local destinations to be supportive for a better mental health among older adults, in particular for women. These findings suggest that walkable built environment attributes may influence depression among older women in an Asian urban context. This study contributed to the literature by examining how walkable urban design may influence elderly's depression in a setting with extreme level of environmental attributes. Investing in urban design to promote walkability may help in reducing the observed gender gap in depression in the Japanese population.