Abstract：
OBJECTIVE: Residential greenspace could alleviate depression - a leading cause of disability. Fewer studies of depression and greenspace have considered major depression, and, to our knowledge, none have considered how climate, which determines vegetation abundance and type, may change the impacts of greenspace. Our aim was to investigate whether residential greenspace is associated with major depression among older adults and explore effect modification by climate.
METHODS: We used biennial interviews between 2008 and 2016 from the Health and Retirement Study. We calculated greenness within walking distance of home addresses as the maximum NDVI for the year of each participant interview averaged within a 1 km buffer. Reflecting clinical criteria, a score of ≥5 on the CIDI-SF indicated major depression in the preceding 12-months. We characterized climate using Köppen-Geiger classifications. To estimate prevalence ratios, we used Poisson regression. Our models adjusted for sociodemographic characteristics, geography, annual sunshine, and bluespace.
RESULTS: The 21,611 eligible participants were 65 ± 10 years old on average, 55% female, 81% White, 12% Black, 10% Hispanic/Latino, and 31% had at least a 4-year college degree. The 12-month prevalence of a major depression was 8%. In adjusted models, more residential greenspace was associated with a lower prevalence of major depression (prevalence ratio per IQR, 0.91; 95% CI, 0.84 to 0.98). There was evidence of effect modification by climate (P forinteraction, 0.062). We observed stronger associations in tropical (prevalence ratio per IQR 0.69; 95% CI, 0.47 to 1.01) and cold (prevalence ratio per IQR, 0.83; 95% CI, 0.74 to 0.93) climates compared to arid (prevalence ratio per IQR 0.99; 95% CI, 0.90 to 1.09) and temperate (prevalence ratio per IQR 0.98; 95% CI, 0.86 to 1.11) climates.
CONCLUSIONS: Residential greenspace may help reduce major depression. However, climate may influence how people benefit from greenspace.
METHODS: We used biennial interviews between 2008 and 2016 from the Health and Retirement Study. We calculated greenness within walking distance of home addresses as the maximum NDVI for the year of each participant interview averaged within a 1 km buffer. Reflecting clinical criteria, a score of ≥5 on the CIDI-SF indicated major depression in the preceding 12-months. We characterized climate using Köppen-Geiger classifications. To estimate prevalence ratios, we used Poisson regression. Our models adjusted for sociodemographic characteristics, geography, annual sunshine, and bluespace.
RESULTS: The 21,611 eligible participants were 65 ± 10 years old on average, 55% female, 81% White, 12% Black, 10% Hispanic/Latino, and 31% had at least a 4-year college degree. The 12-month prevalence of a major depression was 8%. In adjusted models, more residential greenspace was associated with a lower prevalence of major depression (prevalence ratio per IQR, 0.91; 95% CI, 0.84 to 0.98). There was evidence of effect modification by climate (P forinteraction, 0.062). We observed stronger associations in tropical (prevalence ratio per IQR 0.69; 95% CI, 0.47 to 1.01) and cold (prevalence ratio per IQR, 0.83; 95% CI, 0.74 to 0.93) climates compared to arid (prevalence ratio per IQR 0.99; 95% CI, 0.90 to 1.09) and temperate (prevalence ratio per IQR 0.98; 95% CI, 0.86 to 1.11) climates.
CONCLUSIONS: Residential greenspace may help reduce major depression. However, climate may influence how people benefit from greenspace.
摘要：
目标：住宅绿地可以缓解抑郁症-残疾的主要原因。关于抑郁症和绿地的研究较少，认为是重度抑郁症，and,根据我们的知识，没有人考虑过气候，决定了植被的丰度和类型，可能会改变绿地的影响。我们的目的是调查住宅绿地是否与老年人的严重抑郁症有关，并探索气候的影响变化。
方法：我们从健康与退休研究中使用了2008年至2016年的两年期访谈。我们将家庭住址步行距离内的绿色度计算为每个参与者访谈年份在1km缓冲区内的平均最大NDVI。反映临床标准，CIDI-SF评分≥5分表示前12个月出现重度抑郁.我们使用柯本-盖革分类来表征气候。为了估计患病率，我们使用泊松回归。我们的模型根据社会人口统计学特征进行了调整，地理,一年一度的阳光，和蓝调空间。
结果：21,611名符合条件的参与者平均年龄为65±10岁，55%女性，81%白色,12%黑色,10%的西班牙裔/拉丁裔,31%的人至少拥有4年制大学学位。重度抑郁症的12个月患病率为8％。在调整后的模型中，更多的住宅绿地与更低的重度抑郁症患病率相关(每IQR的患病率比，0.91；95%CI，0.84至0.98）。有证据表明气候会改变效应(P-相互作用，0.062).我们观察到热带（每IQR的患病率为0.69；95%CI，0.47至1.01）和寒冷（每IQR的患病率，与干旱（每IQR的患病率为0.99；95％CI为0.90至1.09）和温带（每IQR的患病率为0.98；95％CI为0.86至1.11）相比，气候为0.83；95％CI为0.74至0.93）。
结论：住宅绿地可能有助于减轻重度抑郁症。然而,气候可能会影响人们如何从绿地中受益。
方法：我们从健康与退休研究中使用了2008年至2016年的两年期访谈。我们将家庭住址步行距离内的绿色度计算为每个参与者访谈年份在1km缓冲区内的平均最大NDVI。反映临床标准，CIDI-SF评分≥5分表示前12个月出现重度抑郁.我们使用柯本-盖革分类来表征气候。为了估计患病率，我们使用泊松回归。我们的模型根据社会人口统计学特征进行了调整，地理,一年一度的阳光，和蓝调空间。
结果：21,611名符合条件的参与者平均年龄为65±10岁，55%女性，81%白色,12%黑色,10%的西班牙裔/拉丁裔,31%的人至少拥有4年制大学学位。重度抑郁症的12个月患病率为8％。在调整后的模型中，更多的住宅绿地与更低的重度抑郁症患病率相关(每IQR的患病率比，0.91；95%CI，0.84至0.98）。有证据表明气候会改变效应(P-相互作用，0.062).我们观察到热带（每IQR的患病率为0.69；95%CI，0.47至1.01）和寒冷（每IQR的患病率，与干旱（每IQR的患病率为0.99；95％CI为0.90至1.09）和温带（每IQR的患病率为0.98；95％CI为0.86至1.11）相比，气候为0.83；95％CI为0.74至0.93）。
结论：住宅绿地可能有助于减轻重度抑郁症。然而,气候可能会影响人们如何从绿地中受益。
