Aging & mental health · 2026
Role of age-friendly communities on the association between informal caregiving and depressive symptoms: a multilevel analysis using the Japan Gerontological Evaluation Study.
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Noguchi Taiji, Fujihara Satoko, Ide Kazushige, Jeong Seungwon, Saito Tami, Kondo Katsunori, Ojima Toshiyuki
Аннотация
OBJECTIVES: Age-friendly communities (AFC) promote inclusive and accessible environments that ensure older adults' quality of life and dignity, yet their impact on informal caregivers is unclear. We examined whether AFC modify the association between caregiving and depressive symptoms.
METHOD: Using Japan Gerontological Evaluation Study 2016 data, we analyzed 10,315 older adults across 145 communities. Participants were classfied as caregivers or non-caregivers. The AFC scale assessed community-level age-friendliness in three domains: age-friendly physical environments (barrier-free outdoor spaces, buildings, and transportation), social engagement and communication (community participation, volunteering, and information use), and social inclusion and dementia-friendliness (respect and inclusion for older adults and people with dementia). Multilevel analysis (individuals nested within communities) examined the cross-level interactions of caregiving and community-level age-friendliness on depressive symptoms, assessed using the Geriatric Depression Scale-15.ResultsCaregivers comprised 7.1% of participants and reported higher depressive symptoms than non-caregivers. Social inclusion and dementia-friendliness moderated the caregiving-depressive symptoms association, whereas social engagement and communication amplified this association. Age-friendly physical environments showed no modifications.
CONCLUSION: Inclusive and dementia-friendly AFC aspects may mitigate caregivers' depressive symptoms, while community's physical environments and social interactions may not. Age-friendly initiatives should explicity include informal caregivers as beneficiaries and prioritize inclusive and supportive features.
METHOD: Using Japan Gerontological Evaluation Study 2016 data, we analyzed 10,315 older adults across 145 communities. Participants were classfied as caregivers or non-caregivers. The AFC scale assessed community-level age-friendliness in three domains: age-friendly physical environments (barrier-free outdoor spaces, buildings, and transportation), social engagement and communication (community participation, volunteering, and information use), and social inclusion and dementia-friendliness (respect and inclusion for older adults and people with dementia). Multilevel analysis (individuals nested within communities) examined the cross-level interactions of caregiving and community-level age-friendliness on depressive symptoms, assessed using the Geriatric Depression Scale-15.ResultsCaregivers comprised 7.1% of participants and reported higher depressive symptoms than non-caregivers. Social inclusion and dementia-friendliness moderated the caregiving-depressive symptoms association, whereas social engagement and communication amplified this association. Age-friendly physical environments showed no modifications.
CONCLUSION: Inclusive and dementia-friendly AFC aspects may mitigate caregivers' depressive symptoms, while community's physical environments and social interactions may not. Age-friendly initiatives should explicity include informal caregivers as beneficiaries and prioritize inclusive and supportive features.