Perceived community environment and depressive symptoms among older adults in China: a cross-sectional analysis of physical activity as a moderator.

INTRODUCTION

Perceived community environment is an important contextual factor related to depressive symptoms in later life. However, few studies have examined whether physical activity (PA), a modifiable behavioral factor, moderates this association, particularly across specific aspects of perceived community environment and different types of PA.

METHODS

This study used data from the 2023 China Longitudinal Aging Social Survey, including 9,410 older adults. Linear regression models were used to examine the association between perceived community environment and depressive symptoms and to test the moderating effect of PA. Additional analyses examined specific aspects of the perceived community environment and different PA, including inactive, low PA, moderate PA, and high PA.

RESULTS

Poorer perceived community environment was associated with higher depressive symptom scores, and PA significantly moderated this association, although the incremental explanatory value was small (Δ adjusted R 2 = 0.001). Compared with the inactive group, the perceived community environment slope was weaker in the low PA (B = -0.04, 95% CI: -0.07 to -0.001), moderate PA (B = -0.08, 95% CI: -0.12 to -0.03), and high PA (B = -0.26, 95% CI: -0.50 to -0.02). In community-clustered and weighted sensitivity analyses, the omnibus interaction was no longer statistically significant, although the interaction between perceived community environment and moderate PA remained statistically significant. After Holm correction, significant item-level interactions remained for perceived safety, cleanliness, street lighting, and competence of community staff.

CONCLUSION

This cross-sectional study found that poorer perceived community environment was associated with higher depressive symptom scores among older adults in China, and that this association varied across different PA and specific aspects of community environment. These findings highlight the importance of older adults' own evaluations of their communities and suggest that community-based mental health promotion may benefit from combining improvements in community conditions with accessible and age-appropriate PA opportunities, rather than treating PA as a substitute for environmental improvements. Given the modest improvement in model fit and the cross-sectional design, these findings should be confirmed in longitudinal and intervention studies.