The Longitudinal Association of Perceived Neighborhood Disorder and Lack of Social Cohesion With Depression Among Adults Aged 50 and Over: An Individual Participant Data Meta-Analysis From 16 High-Income Countries

Although residential environment might be an important predictor of depression among older adults, systematic reviews point to a lack of longitudinal investigations and the generalizability of the findings is limited to a few countries. We used longitudinal data collected after 2012 in three surveys, including 15 European countries and the United States, and comprising 32,531 adults aged 50 and over. The risk of perceived neighborhood disorder and lack of social cohesion on depression was estimated using two-stage individual participant data metaanalysis; country-specific parameters were analyzed by meta-regression. We ran additional analyses on individuals reaching retirement. Neighborhood disorder [Odds Ratio (OR)=1.25] and lack of social cohesion (OR=1.76) were significantly associated with depression in the fully adjusted models. In retirement, the risk of depression was even higher (neighborhood disorder: OR=1.35; lack of social cohesion: OR=1.93). Heterogeneity across countries was low and significantly reduced by the addition of country-level income inequality and population density. Perceived neighborhood problems increased the overall risk of depression among adults aged 50 and over. Policies, especially in countries with stronger links between neighborhood and depression, should focus on improving physical environment and supporting social ties in communities, which can reduce depression and contribute to healthy ageing.