Neighborhood Built Environment and Late-Life Depression: A Multilevel Path Analysis in a Chinese Society

Shiyu Lu, Yuqi Liu, Yingqi Guo, Hung Chak Ho, Yimeng Song, Wei Cheng, Cheryl Chui, On Fung Chan, Chris Webster, Rebecca L.H. Chiu, Terry Y. Lum*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

12 Citations (Scopus)


Objectives: Neighborhood built environments (BEs) are increasingly recognized as being associated with late-life depression. However, their pathways are still understudied. This study investigates the mediating effects of physical and social activities (PA and SA) and functional ability (FA) in the relationships between BEs and late-life depression. Methods: We conducted a cross-sectional analysis with data from 2,081 community-dwellers aged 65 years and older in Hong Kong in 2014. Two road-network-based service area buffers (200- and 500-m buffers) adjusted by terrain and slope from participants' residences were created to define the scope of neighborhoods. BEs comprised population density in District Council Constituency Areas, urban greenness, land-use diversity, and neighborhood facilities within 200- and 500-m buffers. Multilevel path analysis models were used. Results: More urban greenness within both buffers and more commercial facilities within a 500-m buffer were directly associated with fewer depressive symptoms. SA mediated the relationship between the number of community facilities and depressive symptoms within a 200-m buffer. Neighborhood urban greenness and the number of commercial facilities had indirect associations on depressive symptoms within a 500-m buffer, which were mediated by FA. Discussion: Our findings have implications for the ecological model of aging. The mediating effects of SA and FA underscore the importance of promoting active social lifestyles and maintaining FA for older adults' mental health in high-density cities. Policy implications on how to build age-friendly communities are discussed. 

Original languageEnglish
Pages (from-to)2143-2154
Number of pages12
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Issue number10
Early online date1 Mar 2021
Publication statusPublished - Dec 2021

Scopus Subject Areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies

User-Defined Keywords

  • Age-friendliness
  • Living environments
  • Mental health
  • Multilevel models


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