Observational studyBMJ open2018
Cross-sectional associations of objectively assessed neighbourhood attributes with depressive symptoms in older adults of an ultra-dense urban environment: the Hong Kong ALECS study.
Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Nature-based interventions for older adults: a systematic review of intervention types and methods, health effects and pathways.Age and ageing · 2025Pooled it
- A systematic review of audit tools for evaluating the quality of green spaces in mental health research.Health & place · 2024Pooled it
- Use of Geographic Information Systems to Explore Associations between Neighborhood Attributes and Mental Health Outcomes in Adults: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Mediating Role of Physical Activity on Associations Between Neighborhood Environments and Mental Health in China.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- The association between street connectivity and depression among older Japanese adults: the JAGES longitudinal study.Scientific reports · 2022Article
- Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature.Brain sciences · 2021Review
- Metro and elderly health in Hong Kong: protocol for a natural experiment study in a high-density city.BMJ open · 2021Article
- Neighbourhood environment and depressive symptoms among the elderly in Hong Kong and Singapore.International journal of health geographics · 2020Article
- Observational
- Objectively-Measured Neighbourhood Attributes as Correlates and Moderators of Quality of Life in Older Adults with Different Living Arrangements: The ALECS Cross-Sectional Study.International journal of environmental research and public health · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aimed to examine the associations between objectively assessed neighbourhood environmental attributes and depressive symptoms in Hong Kong Chinese older adults and the moderating effects of neighbourhood environmental attributes on the associations between living arrangements and depressive symptoms.
designCross-sectional observational study.
settingHong Kong.
participants909 Hong Kong Chinese community dwellers aged 65+ years residing in preselected areas stratified by walkability and socioeconomic status. EXPOSURE AND OUTCOME MEASURES: Attributes of participants' neighbourhood environment were objectively assessed using geographic information systems and environmental audits. Depressive symptoms were measured using the Geriatric Depression Scale.
resultsOverall, pedestrian infrastructure (OR=1.025; P=0.008), connectivity (OR=1.039; P=0.002) and prevalence of public transport stops (OR=1.056; P=0.012) were positively associated with the odds of reporting depressive symptoms. Older adults living alone were at higher risk of reporting any depressive symptoms than those living with others (OR=1.497; P=0.039). This association was moderated by neighbourhood crowdedness, perceptible pollution, access to destinations and presence of people. Residing in neighbourhoods with lower levels of these attributes was associated with increased deleterious effects of living alone. Living in neighbourhoods with lower public transport density also increased the deleterious effects of living alone on the number of depressive symptoms. Those living alone and residing in neighbourhoods with higher levels of connectivity tended to report more depressive symptoms than their counterparts.
conclusionsThe level of access to destinations and social networks across Hong Kong may be sufficiently high to reduce the risk of depressive symptoms in older adults. Yet, exposure to extreme levels of public transport density and associated traffic volumes may increase the risk of depressive symptoms. The provision of good access to a variety of destinations, public transport and public open spaces for socialising in the neighbourhood may help reduce the risk of depressive symptoms in older adults who live alone.
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