The Longitudinal Associations of Perceived Neighborhood Disorder and Lack of Social Cohesion With Depression Among Adults Aged 50 Years or Older: 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 between 2012 and 2017 in 3 surveys including 15 European
countries and the United States and comprising 32,531 adults aged 50 years or older. The risk of depression
according to perceived neighborhood disorder and lack of social cohesion was estimated using 2-stage individualparticipant-data meta-analysis; country-specific parameters were analyzed by meta-regression. We conducted
additional analyses on retired individuals. 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 was significantly reduced by the addition of country-level data
on income inequality and population density. Perceived neighborhood problems increased the overall risk of
depression among adults aged 50 years or older. Policies, especially in countries with stronger links between
neighborhood and depression, should focus on improving the physical environment and supporting social ties in
communities, which can reduce depression and contribute to healthy aging.