Association of residential greenness with geriatric depression among the elderly covered by long-term care insurance in Shanghai

The influence of progeny-Parents family travel on the well-being of the elderly in filial piety culture

Grounded in the cultural context of Chinese filial piety, this study employs structural equation model to analyze survey data from elderly participants. It explores the effect and path of progeny-parents family travel on the elderly's sense of well-being and examines the mediating roles of generational interaction, optimistic emotion, and psychological resilience. The findings indicate that progeny-parents family travel positively influences the well-being of the elderly, with generational interaction, optimistic emotion, and psychological resilience serving as intermediary roles. Theoretically, this study enriches the localized perspective of family travel's psychological and behavioral impact on the elderly. It elucidates the spillover effects of family travel within the framework of filial piety culture, delineates the mechanisms by which family travel enhances elderly well-being, and offers theoretical insights for businesses to develop customized family travel products and services.

Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis

Objective

To explore the effects of green spaces exposure on common psychiatric disorders.

Methods

PubMed, Embase, Web of Science and MEDLINE were screened and articles published prior to November 15, 2023 were included. Analyses were performed on common psychiatric disorders, categorized into depression, anxiety, dementia, schizophrenia, and attention deficit hyperactivity disorder (ADHD). And the subgroup analyses were conducted for depression, anxiety, dementia, and schizophrenia.

Results

In total, 2,0064 studies were retrieved, 59 of which were included in our study; 37 for depression, 14 for anxiety, 8 for dementia, 7 for schizophrenia and 5 for ADHD. Green spaces were found to benefit the moderation of psychiatric disorders (OR = 0.91, 95% CI: 0.89 to 0.92). Green spaces positively influence depression (OR = 0.89, 95% CI: 0.86 to 0.93), regardless of the cross-sectional or cohort studies. Green spaces can also help mitigate the risk of anxiety (OR = 0.94, 95%CI:0.92 to 0.96). As an important index for measuring green spaces, a higher normalized difference vegetation index (NDVI) level related to a lower level of depression (OR = 0.95, 95%CI:0.91 to 0.98) and anxiety (OR = 0.95, 95%:0.92 to 0.98). The protection was also found in dementia (OR = 0.95, 95% CI: 0.93 to 0.96), schizophrenia (OR = 0.74, 95% CI: 0.67 to 0.82), and ADHD (OR = 0.89, 95% CI: 0.86 to 0.92) results.

Conclusion

Green spaces decrease the risk of psychiatric disorders, including depression, anxiety, dementia, schizophrenia, and ADHD. Further studies on green spaces and psychiatric disorders are needed, and more green spaces should be considered in city planning.

Association between residential greenness and depression symptoms in Chinese community-dwelling older adults

BACKGROUND

Studies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions.

OBJECTIVE

This study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China.

METHODS

A cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity.

RESULTS

The prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms.

CONCLUSION

Higher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults.

Objective greenness, connectedness to nature and sunlight levels towards perceived restorativeness in urban nature

The beneficial effect of exposure to nature and immersion in natural environments on perceived well-being is well established. Nevertheless, we acknowledge an emerging need to disentangle the role of specific environmental features from individual factors that encourage a positive person-environment interaction. This study aimed at evaluating the associations between four buffer distances of greenness and dimensions of perceived restorativeness, with connectedness towards nature (CTN) as a confounder variable, in a sample of 312 visitors to a large urban park. Variables investigating ecosystem services (ES, e.g., thermal comfort) were included as covariates. Results revealed differentiated effects of greenness level, sunlight intensity, and connectedness to nature in the pathways towards dimensions of restorativeness. Greenness level at 300 m was associated with Fascination, Scope, and Being Away, while at 500 m was associated with Coherence, Scope, and Being Away. ES was found to be associated with Coherence, while CTN with the other three dimensions of restorativeness. The moderating effect of sunlight level in the relationship between NDVI buffer distances and the total score of perceived restorativeness was also confirmed. The present work is intended to offer insights on the interplay between environmental features and individual differences for implications in several contexts, including the opportunity to develop tailor-made planning for urban forestry.

Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era

Objective

The COVID-19 pandemic has changed peoples’ routine of daily living and posed major risks to global health and economy. Few studies have examined differential impacts of economic factors on health during pandemic compared to pre-pandemic. We aimed to compare the strength of associations between perceived health and socioeconomic position (household income, educational attainment, and employment) estimated before and during the pandemic.

Methods

Two waves of nationwide survey [on 2018(T1;n = 1200) and 2021(T2;n = 1000)] were done for 2200 community adults. A balanced distribution of confounders (demographics and socioeconomic position) were achieved across the T2 and T1 by use of the inverse probability of treatment weighting. Distributions of perceived health [= (excellent or very good)/(bad, fair, or good)] for physical-mental-social-spiritual subdomains were compared between T1 and T2. Odds of bad/fair/good health for demographics and socioeconomic position were obtained by univariate logistic regression. Adjusted odds (aOR) of bad/fair/good health in lower household income(< 3000 U.S. dollars/month) were retrieved using the multiple hierarchical logistic regression models of T1 and T2.

Results

Perceived health of excellent/very good at T2 was higher than T1 for physical(T1 = 36.05%, T2 = 39.13%; P = 0.04), but were lower for mental(T1 = 38.71%, T2 = 35.17%; P = 0.01) and social(T1 = 42.48%, T2 = 35.17%; P < 0.001) subdomains. Odds of bad/fair/good health were significantly increased at T2 than T1 for household income (physical-mental-social; all Ps < 0.001) and educational attainment (social; P = 0.04) but not for employment (all Ps > 0.05). AORs of bad/fair/good health in lower household income were stronger in T2 than T1, for mental [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.82(P < 0.001)], physical [aOR (95% CI) = 2.64(2.05–3.41) in T2, 1.50(1.18–1.90) in T1; aOR difference = 1.14(P < 0.001)] and social [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.35(P = 0.049)] subdomains.

Conclusions

Risks of perceived health worsening for mental and social subdomains in people with lower monthly household income or lower educational attainment became stronger during the COVID-19 pandemic compared to pre-pandemic era. In consideration of the prolonged pandemic as of mid-2022, policies aiming not only to sustain the monthly household income and compulsory education but also to actively enhance the perceived mental-social health status have to be executed and maintained.

Residential greenness is associated with disease severity among COVID-19 patients aged over 45 years in Wuhan, China

Evidence regarding environmental factors associated with disease severity of COVID-19 remained scarce. This study aimed to investigate the association of residential greenness exposure with COVID-19 severity applying a retrospective cross-sectional study in Wuhan, China. We included 30,253 COVID-19 cases aged over 45 years from January 1 to February 27, 2020. Residential greenness was quantitatively assessed using normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). A multilevel generalized linear model using Poisson regression was implemented to analyze the association between greenness exposure and disease severity of COVID-19, after adjusting for potential covariates. A linear exposure-response relationship was found between greenness and COVID-19 severity. In the adjusted model, one 0.1 unit increase of NDVI and EVI in the 1000-m buffer radius was significantly associated with a 7.6% (95% confidence interval (CI): 4.0%, 11.1%) and 10.0% (95% CI: 5.1%, 14.7%) reduction of the prevalence of COVID-19 severity, respectively. The effect of residential greenness seemed to be more pronounced among participants with lower population density and economic levels. Air pollutants mediated 0.82~12.08% of the greenness and COVID-19 severity association, particularly to nitrogen dioxide. Sensitivity analyses suggested the robustness of the results. Our findings suggested that residential greenness exposure was beneficial to reduce the prevalence of COVID-19 severity.