Older people, the natural environment and common mental disorders: cross-sectional results from the Cognitive Function and Ageing Study

Yu-Tzu Wu, Matthew Prina, Andy Jones, Fiona Matthews, Carol Brayne

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Objectives: To explore the hypothesis that higher exposure to natural environments in local areas is associated with a lower odds of depression and anxiety in later life

Design: A cross-sectional study based on the year-10 interview of the Medical Research Council Cognitive Function and Ageing Study (CFAS), a population-based study of ageing in the UK. Postcodes of the CFAS participants were mapped onto small geographic units, Lower-layer Super Output Areas (LSOA) and linked to environmental data from government databases. The natural environment was characterised as the percentage of green space and private
gardens in each LSOA based on the UK Generalised Land Use 2001 Dataset.
Participants 2424 people aged 74 and over in the CFAS year-10 follow-up interview (2001) from four English centres (Cambridgeshire, Nottingham, Newcastle and Oxford)

Main outcome measures: Depression and anxiety; clinical and sub-threshold cases were identified using the Geriatric Mental State Examination (GMS) package and its associated diagnostic algorithm: the Automated Geriatric Examination for Computer Assisted Taxonomy.

Results: Compared to the lowest quartile, living in the highest quartile of neighbourhood natural environment provision was associated with a reduced odds of sub-threshold depression (OR: 0.66, 95% CI 0.46 to 0.95), anxiety symptoms (OR: 0.62, 95% CI 0.46 to 0.83) and their co-occurrence (OR: 0.55, 95% CI 0.35 to 0.84) after adjusting for individual level factors. Controlling for area deprivation attenuated the strength of associations for sub-threshold
depression by 20% but not for anxiety symptoms or for co-occurrence of the conditions.

Conclusions: A high exposure to natural environments (green space and gardens) in communities was associated with fewer mental disorders amongst older people. Increasing provision of green environments in local areas could be a potential population-level intervention to improve mental health amongst older people.
Original languageEnglish
Article numbere007936
JournalBMJ Open
Issue number9
Early online date16 Sep 2015
Publication statusPublished - Sep 2015

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