Article Text
Abstract
Background Emerging literature emphasises the association between neighbourhood conditions and late life depression. Childhood experiences, crucial for life course development of mental health, may modify how neighbourhood affects subsequent depression. This study assessed the longitudinal associations between perceived neighbourhood and depression among older adults, and tested whether these associations varied by exposure to different childhood stressors.
Methods Data were drawn from the cross-national SHARE Survey, a 10-year probability sampled cohort study, representative for European adults aged 50 and over. Non-institutionalised respondents were included, if they provided answers on neighbourhood and depression at baseline (waves 1 or 2), participated in the life history assessment (wave 3), and had at least one assessment of depression during the follow-up (waves 4–6). Neighbourhood was assessed with four binary questions, capturing the subjective perception of access to services (public transportation, neighbourhood amenities) and neighbourhood nuisance (crime, air pollution and environmental problems) in the area surrounding the place of residence. Childhood stressors, defined as socioeconomic conditions, adverse experiences and health problems, were derived from retrospectively collected questions. Depression was measured with the EURO-D scale; the cut-off score of ≥4 indicated clinically significant levels of depressive symptoms. Multilevel logistic regression estimated the risk of depression. We conducted sensitivity analyses by using continuous EURO-D scores in multilevel linear regression and adjusting final models for urban-rural difference. All models were conducted in R Studio.
Results The final sample comprised 10,487 participants with 18,899 observations during follow-up, living in 13 European countries. After controlling for sociodemographic and health covariates, as well as baseline depression, access to services were negatively (OR=0.81, 95% CI 0.71–0.93) and neighbourhood nuisance positively (OR=1.29, 95% CI 1.12–1.47) associated with depression during follow-up. We found interactions between neighbourhood and childhood socioeconomic conditions, but not with adverse experiences and health problems. While older adults who grew up in better childhood socioeconomic conditions benefited more from living in a residential area with good access to services, they were at higher risk of developing depression when residing in areas with more neighbourhood nuisances.
Conclusion Older adults’ mental health can benefit from better access to services, while neighbourhood nuisance increase the risk of depression. Importantly, socioeconomic circumstances in early life may influence vulnerability to neighbourhood effects. Limitations, concerning self-reported measures and retrospectively collected childhood indicators warrant for cautious interpretations. Future research on neighbourhood effects should prioritise the implementation of the life course approach, while policy should consider neighbourhood as a public health opportunity supporting healthy ageing.