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. 2017 Aug 15:218:359-364.
doi: 10.1016/j.jad.2017.05.001. Epub 2017 May 5.

Micro-scale environment and mental health in later life: Results from the Cognitive Function and Ageing Study II (CFAS II)

Yu-Tzu Wu  1 , A Matthew Prina  2 , Andy Jones  3 , Linda E Barnes  4 , Fiona E Matthews  5 , Carol Brayne  4 ; MRC CFAS
Affiliations

Micro-scale environment and mental health in later life: Results from the Cognitive Function and Ageing Study II (CFAS II)

Yu-Tzu Wu et al. J Affect Disord. .

Abstract

Background: Poor micro-scale environmental features, such as graffiti and broken windows, have been associated with crime and signs of social disorder with a potential impact on mental health. The aim of this study is to investigate the association between micro-scale environment and mental health problems in later life, including cognitive (cognitive impairment and dementia) and common mental disorders (depressive and anxiety symptoms).

Methods: The method of visual image audits was used to collect micro-scale environmental data for 3590 participants in the Cognitive Function and Ageing Study II, a population-based multicentre cohort of people aged 65 or above in England. Multilevel logistic regression was used to examine the associations between the quality of micro-scale environment and mental health problems taking into account urban/rural difference.

Results: Poor quality of micro-scale environment was associated with nearly 20% increased odds of depressive (OR: 1.19; 95% CI: 0.99, 1.44) and anxiety symptoms (OR: 1.17; 95% CI: 0.99, 1.38) while the direction of association for cognitive disorders differed across urban and rural settings. Although higher odds of cognitive disorders were found in rural settings, living in a poor quality environment was associated with nearly twice higher odds of cognitive impairment (OR: 1.88; 95% CI: 1.18, 2.97) in urban conurbations but 20% lower odds in rural areas (OR: 0.80; 95% CI: 0.57, 1.11).

Limitations: The causal direction could not be fully determined due to the cross-sectional nature of the data. The visual nature of the environmental assessment tool means it likely does not fully capture features related to the availability of local support services, or opportunities for social participation and interaction.

Conclusions: The quality of micro-scale environment appears to be important to mental health in older people. Interventions may incorporate the environmental aspect to reduce cognitive and common mental disorders.

Keywords: Anxiety; Cognitive disorder; Depression; Environment; Neighbourhood; Older age.

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Figures

Fig. 1
Fig. 1
Stratified associations between cognitive disorders and REAT groups (high vs low) across three rural/urban categories.
See this image and copyright information in PMC

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