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Mental health is important in older age; neighborhood environment is considered a protective factor of depression. Research has established that a critical indicator of neighborhood environment, street connectivity, is related to older people's health. However, little is known about the relationship between street connectivity and depression. We examined the relationship between street connectivity and depression among older people. Using Japan Gerontological Evaluation Study 2013-2016, the target population comprised 24,141 independent older people without depression (Geriatric Depression Scale scores below 5) in 2013. The outcome variable was depression in 2016; the explanatory variable was street connectivity calculated by intersection density and space syntax within 800 m around the subject's neighborhood in 2013. We used logistic regression analysis to calculate the odds ratio and 95% confidence interval for the new occurrence of depression among participants in 2016. This analysis demonstrated incidence of new depression after 3 years that is 17% and 14% lower among participations living in high-intersection density and high-street-connectivity areas, respectively, than those living in low-intersection density and low-street-connectivity areas. The association held after adjusting for physical activities and social interaction. Given the established connection between street connectivity and mental health, the findings can contribute to healthy urban planning., (© 2022. The Author(s).)

Objectives　In this study, we aim to clarify the optimal threshold for the frequency of volunteer group participation among older people aged 65 years and above, which is expected to prevent the risk of developing depression.Methods　We utilized longitudinal data from 2013 to 2016, collated by the Japan Gerontological Evaluation Study for people aged ≥65 years living in 24 municipalities and not certified as requiring long-term care. In addition, those who were not depressed in 2013 (≥5 points on the Geriatric Depression Scale-15) were followed up for 3 years and classified according to the frequency of participation in the volunteer group in 2013 (≥once per year, ≥once per month, ≥once per week). The odds ratio (OR) of being newly depressed in 2016 was determined using the propensity score matching method and t-test.Results　The frequency of volunteer group participation for 9,722 (25.0%), 6,026 (15.5%), and 2,735 (7.0%) older individuals was≥once per year, once per month, and once per week, respectively. A comparison of the balanced attributes of the volunteer group participation with those of the non-participation group using propensity scores revealed that the risk of developing depressive symptoms was significantly lower in the former compared with the latter for the frequency of ≥once per month and OR of 0.82 (95% confidence interval: 0.72, 0.93). The ORs were 0.92 (0.83, 1.02) and 0.82 (0.68, 1.00) for the ≥once per year and once per week groups, respectively.Conclusion　Older people's participation in a volunteer group ≥once per month was effective in reducing the risk of developing depressive symptoms after 3 years. This suggests that increasing the opportunities and community places where older people can be involved as volunteers even once a month may be employed as an effective measure to prevent depression.

Background: Rurality can reflect many aspects of the community, including community characteristics that may be associated with mental health. In this study, we focused on geographical units to address multiple layers of a rural environment. By evaluating rurality at both the municipality and neighborhood (i.e., a smaller unit within a municipality) levels in Japan, we aimed to elucidate the relationship between depression and rurality. To explore the mechanisms linking rurality and depression, we examined how the association between rurality and depression can be explained by community social capital according to geographical units., Methods: We used cross-sectional data from the 2016 wave of the Japan Gerontological Evaluation Study involving 144,822 respondents aged 65 years or older residing in 937 neighborhoods across 39 municipalities. The population density quintile for municipality-level rurality and the quintile for the time required to reach densely inhabited districts for neighborhood-level rurality were used. We calculated the prevalence ratios of depressive symptoms by gender using a three-level (individual, neighborhood, and municipality) Poisson regression. Community social capital was assessed using three components: civic participation, social cohesion, and reciprocity., Results: The prevalence of depressive symptoms was higher in municipalities with lower population density than those with the highest population density; the ratios were 1.22 (95% confidence intervals: 1.15, 1.30) for men and 1.22 (1.13, 1.31) for women. In contrast, when evaluating rurality at the neighborhood level, the prevalence of depressive symptoms was 0.9 times lower for men in rural areas; no such association was observed for women. In rural municipalities, community civic participation was associated with an increased risk of depressive symptoms. In rural neighborhoods, community social cohesion and reciprocity were linked to a lower risk of depressive symptoms., Conclusions: The association between rurality and depression varied according to geographical unit. In rural municipalities, the risk of depression may be higher for both men and women, and the presence of an environment conducive to civic participation may contribute to a higher risk of depression, as observed in this study. The risk of depression in men may be lower in rural neighborhoods in Japan, which may be related to high social cohesion and reciprocity., (© 2021. The Author(s).)

Background: The current study aimed to investigate the contextual effect of volunteer group participation on subsequent depressive symptoms in older people., Methods: We analyzed the longitudinal data of 37,552 people aged 65 years and older in 24 municipalities surveyed in the Japan Gerontological Evaluation Study. Volunteer group participation of older people was assessed in 2013 by one question and depressive symptoms were assessed by the Geriatric Depression Scale 15 in 2016. To investigate a contextual effect, we aggregated individual-level volunteer group participation by each residence area as a community-level independent variable. We conducted a two-level multilevel Poisson regression analysis using the Random Intercepts and Fixed Slopes Model., Results: The average proportion of community-level volunteer group participation was 10.6%. The results of the Poisson regression analysis showed that community-level volunteer group participation reduced the risk for the onset of depressive symptoms by 13% with a 10 percentage point increase in participation, after adjusting for sex, age, population density, total annual sunshine hours and annual rainfall (incident rate ratio, 0.87; 95% confidence interval, 0.78-0.98)., Conclusions: Older people living in areas with higher volunteer group participation had a lower risk of developing depressive symptoms regardless of whether or not they participated in a volunteer group.

Background: Farmers may have an increased risk for poor mental health. In connection with this, factors specific to the neighborhood environment such as farm density and the type of agriculture, might be important for mental wellbeing. In this study we aimed to clarify the cross-level interaction on depressive symptoms between farm density at the neighborhood level by type of agriculture and the longest occupation of individuals (farmer or non-farmer)., Methods: Data came from the 2016 wave of the Japan Gerontological Evaluation Study (JAGES) that were linked to governmental agricultural data. Information was analyzed from 147,549 respondents aged 65 years or older, residing in 1024 neighborhoods in 39 municipalities. We calculated farm (crop or animal husbandry) density at the neighborhood level, dividing the number of agricultural management entities by the population. Three-level (individual, neighborhood, and municipality) Poisson regression analysis was used to calculate the prevalence rate ratios of depressive symptoms., Results: The prevalence of depressive symptoms was higher among individuals whose longest occupation was farmer compared to non-farmer. The estimated probability of depressive symptoms by a cross-level interaction analysis showed that among farmers of both genders, those who were residing in neighborhoods where the farm density was low had a higher prevalence of depressive symptoms, regardless of the type of agriculture. The slope of the relationship between depressive symptoms and animal husbandry farm density varied by occupation, with a higher prevalence of depressive symptoms observed in male farmers compared to male non-farmers., Conclusions: The high prevalence of depressive symptoms among farmers in neighborhoods with a low farm density may reflect a scarcity of formal and informal social support in such communities. The health effects of the neighborhood environment on farmers, such as farm density, which may vary by the type of agriculture, should be further researched.

Depression among older adults is one of the most critical public health issues. The proximity of elementary schools has been positively associated with neighborhood social cohesion and quality of life. However, no studies have identified an association between the proximity of elementary school and older adults' mental health. Therefore, this study aimed to examine the association between the proximity of elementary schools, one of the core facilities of neighborhood communities in Japan, and depression in older adults. A total of 131,871 participants (63,430 men 73.7 ± 6.1 years, 68,441 women 73.8 ± 6.2 years) were analyzed from the Japan Gerontological Evaluation Study (JAGES) 2016 survey. Logistic regression analysis showed that there was no association between distance to elementary school and depression among males. However, among females, compared with the participants living within 400 m from the nearest elementary school, the odds ratio of depression for those living between 400 and 799 m and more than 800 m away were 1.06 (95% confidence interval (CI) 1.00-1.12) and 1.07 (95% CI 1.00-1.15), respectively. The findings may be useful when considering the design of communities around elementary schools and the planning of facilities as a population-based approach to promote mental health of older women.

Depression in older adults is a public health challenge. We aimed to clarify the relationship between depression in older adults and three types of neighborhood greenspaces: trees, grasslands, and fields. We utilized data from the Japan Gerontological Evaluation Study (JAGES) performed in 2016. Multilevel logistic regression analysis was used for non-stratified and stratified analyses for the urban-rural regions. The target population comprised 126,878 older adults (age ≥ 65 years) who responded to the depression questions and were living in 881 neighborhoods in Japan. Depression was diagnosed based on a Geriatric Depression Scale score ≥5, and 20.4% of the study population had depression. In the pre-stratification analysis, areas with more greenspaces revealed lower odds of depression (odds ratio (OR) 0.95, 95% confidence interval (CI) 0.85-0.95). In urban areas, more trees correlated with lower odds of depression (OR 0.94, 95% CI 0.89-1.00). In rural areas, moderate amounts of grassland were associated with lower odds of depression compared to areas with fewer grasslands (OR 0.91, 95% CI 0.83-1.00). We found that urban areas with higher tree density and rural areas with moderate amounts of grassland were associated with lower odds of depression.

Widowhood and living alone are linked to increased risk of depression. We examined prospectively whether community-level social capital can mitigate the adverse impact of widowhood and living alone on depressive symptoms. We used data of the Japan Gerontological Evaluation Study of functionally independent adults aged 65 years or older. Three waves of surveys were collected in 2010, 2013 and 2016. We conducted gender-stratified multilevel linear regression to examine the moderating effects of community-level social capital on depressive symptoms (as assessed by the 15-point Geriatric Depression Scale) associated with widowhood and living alone. Widowhood in the past 12 months in combination with living alone was associated with a marked worsening in depressive symptoms among men (beta coefficient = 1.67; 95% confidence interval: 1.38, 1.95). Community-level civic participation, but not social cohesion or reciprocity, was associated with lower depressive symptoms in men and women. In addition, community-level civic participation moderated the association between depressive symptoms and recent widowhood/living alone among men (coefficient per 1 standard deviation = -0.30; 95% confidence interval: -0.59, -0.02). We found no significant effect modification of community-level social capital on depressive symptoms associated with widowhood and living alone among women. Communities with greater civic participation appear to mitigate the onset of depressive symptoms among recently widowed men living alone. Promotion of community activities might be an effective community-level intervention to promote mental health in this vulnerable group., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: About one in ten mothers experience postpartum depression (PPD) in Japan. Although the individual and social risk factors of depression have been reported, few studies have focused on the neighborhood environmental features. In this study, we examined the association between neighborhood environmental features and PPD symptoms among Japanese women., Methods: Questionnaire survey including women who participated in 3- or 4-month health checkup in Nagoya City, Japan in 2012 was used. PPD symptoms were evaluated using Edinburgh Postnatal Depression Scale (EPDS). As the neighborhood places where postpartum mothers often visit, we measured availability of grocery stores, community centers and asobiba (playground for children) within residential neighborhood unit using geographic information system. A multilevel analysis was conducted on 2,298 individuals nested within 388 school districts using Stata 15.1 software., Results: Mothers who live in the neighborhood with more number of asobiba had lower EPDS score, even after adjustment for individual factors (B: -0.12, 95%CI: -0.24, -0.01), and additional adjustment for other neighborhood environmental factors (B: -0.14, 95%CI: -0.27, -0.02)., Limitation: Our cross-sectional design limits to draw causal inferences. As for the evaluation of PPD symptoms, no diagnosis has been made. Moreover, we do not have the information on the accessibility to transportation, and the exact residential location of the survey respondents., Conclusion: Our findings suggest that the availability of asobiba in the community has a protective effect on PPD symptoms. Providing more asobiba in the neighborhood for new mothers may be a viable preventive strategy for PPD symptoms., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2019. Published by Elsevier B.V.)

Purpose: Community-level group participation is a structural aspect of social capital that may have a contextual influence on an individual's health. Herein, we sought to investigate a contextual relationship between community-level prevalence of sports group participation and depressive symptoms in older individuals., Methods: We used data from the 2010 Japan Gerontological Evaluation Study, a population-based, cross-sectional study of individuals 65 yr or older without long-term care needs in Japan. Overall, 74,681 participants in 516 communities were analyzed. Depressive symptoms were diagnosed as a 15-item Geriatric Depression Scale score of ≥5. Participation in a sports group 1 d·month or more often was defined as "participation." For this study, we applied two-level multilevel Poisson regression analysis stratified by sex, calculated prevalence ratios (PR), and 95% confidence intervals (CI)., Results: Overall, 17,420 individuals (23.3%) had depressive symptoms, and 16,915 (22.6%) participated in a sports group. Higher prevalence of community-level sports group participation had a statistically significant relationship with a lower likelihood of depressive symptoms (male: PR, 0.89 (95% CI, 0.85-0.92); female: PR, 0.96 (95% CI, 0.92-0.99), estimated by 10% of participation proportion) after adjusting for individual-level sports group participation, age, diseases, family form, alcohol, smoking, education, equivalent income, and population density. We found statistically significant cross-level interaction terms in male participants only (PR, 0.86; 95% CI, 0.77-0.95)., Conclusions: We found a contextual preventive relationship between community-level sports group participation and depressive symptoms in older individuals. Therefore, promoting sports groups in a community may be effective as a population-based strategy for the prevention of depression in older individuals. Furthermore, the benefit may favor male sports group participants.

Relative income deprivation (RID) is a known risk factor for poor health. Previous research has proposed several measures to assess RID, e.g., Income Rank and the Yitzhaki Index. Hounkpatin et al. (2020) presented a new approach – the C R ˜ i index – to account for the observation that individuals are more sensitive to the differences in incomes of others who are closer to them, rather than to comparisons with incomes of others far above them. Using a Japanese nationwide cohort of older adults (n = 62,438; mean [SD] age: 73.0 [5.6] years), this study compared the performance of alternative indices of RID in predicting health outcomes (depressive symptoms, functional capacity, and self-rated health), as well as the use of alternative C R ˜ i index weights (α weight range: −0.9 to 0.9). When 0 < α < 1 , higher income differences lead to a more significant increase in relative deprivation, while when −1< α <0, excessively high incomes contribute less to the relative deprivation of lower income individuals in the same reference group. Results showed that all measures of relative income deprivation were associated with deteriorating mental and physical health among older Japanese adults. However, while the C R ˜ i index consistently outperformed the Yitzhaki Index, this did not hold true invariably when compared to the Income Rank – depending on the health outcome and the reference group. Also, while negative α parameters showed a good statistical fit in most models, the findings were not conclusive – the best-fitting C R ˜ i weight parameters ranged from −0.9 to 0.9. Therefore, a clear direction for the contribution of higher incomes to relative deprivation could not be established based on the study population. • Relative income deprivation was consistently associated with mental and physical health. • The novel C R ˜ i index consistently outperformed the Yitzhaki Index. • The performance of the C R ˜ i index was comparable to the Income Rank. • No conclusive evidence was found on the direction or magnitude of the best-fitting α parameter. [ABSTRACT FROM AUTHOR]