Neighborhood Predictors of Mental Health of Older Americans: Evidence from a 5-year Longitudinal Study

Background: With increasing dependence on other people in old age, environmental resources become an important asset for older adults to experience healthy aging. Neighborhood conditions, therefore, are some of the multiple factors that contribute to the mental wellbeing of older adults. This study investigated whether and which neighborhood factors predicted depression and anxiety among American older adults followed up for over five years within the same neighborhood. Methods: Two waves of publicly available longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) were utilized. A hierarchical multiple regression model analysis was employed to explore the association between neighborhood factors and mental health. The secondary data contained a cohort of 1,731 older adults. Outcome measures were depression using the 11-item CES-Depression Scale and anxiety using the 7-item HADS Anxiety Scale. The predictors were four neighborhood factors: Social cohesion, social ties, neighborhood problems, and perceived neighborhood danger. We also adjusted for demographic and physical health characteristics. Results: The mean age of the respondents was 71.4 ± 6.5 years and were mostly females (55.5%) and Whites (74.4%). Lower Neighborhood Social Cohesion and a higher Perceived Neighborhood Danger significantly predicted depression. However, the model only explained 2.8% of the variance in Depression. None of the neighborhood factors predicted depression following 5 years after adjusting for demographic and physical health characteristics and baseline depression, but the model significantly improved to 32.5%. Neighborhood problem was the only significant predictor of anxiety after adjusting for other covariates and explained 27.8% of the variance in anxiety. Conclusion: The study sheds some light on the complexity of the relationship between neighborhood and mental health in older adults. Moreover, our findings suggest that city planners and policymakers can influence healthy aging through the proper mapping of a city and the reduction in disorderliness within communities for older adults. Therefore, future policy development and interventions should target improving both physical and social environments to enhancing the mental wellbeing of older adults.