RATIONALE: Two gaps in the literature arise on the relationship between social cohesion and depressive disorders. Firstly, there is a lack of studies comparing countries with diverse communal bonds and population-level differences in depression. Secondly, most work on explanatory mechanisms has overwhelmingly focussed on social network and social support pathways. OBJECTIVES: We compared the prospective association between perceived neighbourhood social cohesion and depressive symptoms among older adults in England, the Czech Republic, Poland and Russia; and examined whether psychological and health behavioural pathways mediated this association. METHODS: Harmonized data on 26,081 adults from the English Longitudinal Study of Ageing (ELSA), and the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) studies were analysed. Prospective associations between perceived neighbourhood social cohesion at baseline and depressive symptoms at follow-up were assessed using multivariable negative binomial regression. The psychological (through control of life, and control at home) and health behavioural (through smoking and drinking) pathways were tested using path analysis. RESULTS: Low cohesion predicted a higher number of depressive symptoms at follow-up among English (b = 0.106, p = 0.001), Czech (b=0.203, p < 0.001), Polish (0.115, p < 0.001) and Russian adults (b = 0.087, p < 0.001). Indirect effects via psychological mechanisms were strong and explained 64% (Poland), 82% (Russia), 84% (England) and 95% (Czech Republic) of the total indirect effects from low cohesion to elevated symptoms in these populations. Indirect effects via health behaviours were much weaker by comparison. CONCLUSIONS: Prospective associations between low social cohesion and increased depressive symptoms were largely congruent among older adults from England and three Central and Eastern European countries. These associations operated via a psychological, but not a health behavioural, pathway among ageing adults living in diverse parts of Europe.

Centre for Environmental Health Monitoring National Institute of Public Health Šrobárova 48 10042 Prague Czech Republic

Institute of Public Health Faculty of Health Sciences Jagiellonian University Medical College Grzegórzecka 20 31 531 Krakow Poland

Research Department of Epidemiology and Public Health University College London 1 19 Torrington Place London WC1E 7HB United Kingdom

Research Department of Epidemiology and Public Health University College London 1 19 Torrington Place London WC1E 7HB United Kingdom; Faculty of Physical Education and Sport Charles University José Martího 31 Prague 6 162 52 Czech Republic

Research Institute of Internal and Preventive Medicine Branch of the Institute of Cytology and Genetics SB RAS Prospekt Lavrentyeva 10 630090 Novosibirsk Russia; Novosibirsk State Medical University Borisa Bogatkova 175 1 630089 Novosibirsk Russia

See more in PubMed

Abbott P., Sapsford R. Life satisfaction in post-Soviet Russia and Ukraine. J. Happiness Stud. 2006;7:251–287.

Alwin D.F., Hauser R.M. The decomposition of effects in path analysis. Am. Sociol. Rev. 1975;40:37–47.

Anderson R., Unzicker K. Eurofound and Bertelsmann Stiftung; Dublin: 2014. Social Cohesion and Well-Being in the EU; pp. 1–24.

Baron R.M., Kenny D.A. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J. Personal. Soc. Psychol. 1986;51:1173–1182. PubMed

Beekman A.T., Deeg D., Van Limbeek J., Braam A.W., De Vries M.Z., Van Tilburg W. Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands. Psychol. Med. 1997;27:231–235. PubMed

Berkman L.F., Glass T., Brissette I., Seeman T.E. From social integration to health: durkheim in the new millennium. Soc. Sci. Med. 2000;51:843–857. PubMed

Blair A., Ross N.A., Gariepy G., Schmitz N. How do neighborhoods affect depression outcomes? A realist review and a call for the examination of causal pathways. Soc. Psychiatry Psychiatr. Epidemiol. 2014;49:873–887. PubMed

Bobak M., Pikhart H., Hertzman C., Rose R., Marmot M. Socioeconomic factors, perceived control and self-reported health in Russia. A cross-sectional survey. Soc. Sci. Med. 1998;47:269–279. PubMed

Brook Lyndhurst Ltd . Department for Environment Food and Rural Affairs, UK; London: 2010. Social Capital and Quality of Life in Rural Areas; pp. 1–145.

Castro-Costa E., Dewey M., Stewart R., Banerjee S., Huppert F., Mendonca-Lima C. Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study. Br. J. Psychiatry. 2007;191:393–401. PubMed

Choi N.G., Kim J., DiNitto D.M., Marti C.N. Perceived social cohesion, frequency of going out, and depressive symptoms in older adults: examination of longitudinal relationships. Gerontol. Geriatr. Med. 2015;1:1–11. PubMed PMC

Cuijpers P., Smit F. Excess mortality in depression: a meta-analysis of community studies. J. Affect. Disord. 2002;72:227–236. PubMed

De Silva M.J., McKenzie K., Harpham T., Huttly S.R.A. Social capital and mental illness: a systematic review. J. Epidemiol. Community Health. 2005;59:619–627. PubMed PMC

Dershem L.D., Patsiorkovski V.V., O'Brien D.J. The use of the CES-D for measuring symptoms of depression in three rural Russian villages. Soc. Indic. Res. 1996;39:89–108.

Ditlevsen S., Christensen U., Lynch J., Damsgaard M.T., Keiding N. The mediation proportion: a structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable. Epidemiology. 2005;16:114–120. PubMed

Dojka E., Górkiewicz M., Pajak A. Wartosc pomiarowa skali CES-D do oceny depresji w populacji polskiej [Psychometric value of CES-D scale for the assessment of depression in Polish population] Psychiatr. Pol. 2003;37:281–292. PubMed

Ehsan A.M., De Silva M.J. Social capital and common mental disorder: a systematic review. J. Epidemiol. Community Health. 2015;69:1021–1028. PubMed

Fortier I., Raina P., Van den Heuvel E.R., Griffith L.E., Craig C., Saliba M. Maelstrom Research guidelines for rigorous retrospective data harmonization. Int. J. Epidemiol. 2016;46:103–115. PubMed PMC

Haigh E.A.P., Bogucki O.E., Sigmon S.T., Blazer D.G. Depression among older adults: a 20-year update on five common myths and misconceptions. Am. J. Geriatr. Psychiatry. 2018;26:107–122. PubMed

Hall J., Sammons P. Mediation, moderation and interaction. In: Teo T., editor. Handbook of Quantitative Methods for Educational Research. Sense Publishers; Rotterdam: 2013. pp. 267–286.

Hertzog C., Van Alstine J., Usala P., Hultsch D., Dixon R. Measurement properties of the center for epidemiological studies depression scale (CES-D) in older populations. Psychol. Assess. 1990;2:64–72.

Horvat P., Gardiner J., Kubinova R., Pajak A., Tamosiunas A., Schöttker B. Serum folate, vitamin B-12 and cognitive function in middle and older age: the HAPIEE study. Exp. Gerontol. 2016;76:33–38. PubMed PMC

Hsieh N. Economic security, social cohesion, and depression disparities in post-transition societies: a comparison of older adults in China and Russia. J. Health Soc. Behav. 2015;56:534–551. PubMed PMC

Hu Y., Pikhart H., Malyutina S., Pajak A., Kubinova R., Nikitin Y. Alcohol consumption and physical functioning among middle-aged and older adults in Central and Eastern Europe: results from the HAPIEE study. Age Ageing. 2015;44:84–89. PubMed PMC

Julien D., Richard L., Gauvin L., Kestens Y. Neighborhood characteristics and depressive mood among older adults: an integrative review. Int. Psychogeriatr. 2012;24:1207–1225. PubMed

Kääriäinen J., Lehtonen H. The variety of social capital in welfare state regimes - a comparative study of 21 countries. Eur. Soc. 2006;8:27–57.

Karhina K., Ng N., Ghazinour M., Eriksson M. Gender differences in the association between cognitive social capital, self-rated health, and depressive symptoms: a comparative analysis of Sweden and Ukraine. Int. J. Ment. Health Syst. 2016;10:1–14. PubMed PMC

Kawachi I., Berkman L.F. Social cohesion, social capital, and health. In: Berkman L.F., Kawachi I., editors. Social Epidemiology. Oxford University Press; New York: 2000. pp. 174–190.

Kawachi I., Berkman L.F. Social ties and mental health. J. Urban Health. 2001;78:458–467. PubMed PMC

Kawachi I., Kim D., Coutts A., Subramanian S.V. Commentary: reconciling the three accounts of social capital. Int. J. Epidemiol. 2004;33:682–690. PubMed

Kok R., Avendano M., Bago d'Uva T., Mackenbach J. Can reporting heterogeneity explain differences in depressive symptoms across Europe? Soc. Indic. Res. 2012;105:191–210. PubMed PMC

Marmot M., Bobak M. Social and economic changes and health in Europe East and west. Eur. Rev. 2005;13:15–31.

Osecka L. Czech Academy of Sciences; Brno: 1999. Skala Deprese CES–D–Psychometricka Analyza [Depression Scale CES–D: Psychometric Analysis]

Peasey A., Bobak M., Kubinova R., Malyutina S., Pajak A., Tamosiunas A. Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: rationale and design of the HAPIEE study. BMC Public Health. 2006;6 255-255. PubMed PMC

Penninx B.H., Geerlings S.W., Deeg D.H., van Eijk J.M., van Tilburg W., Beekman A.F. Minor and major depression and the risk of death in older persons. Arch. Gen. Psychiatr. 1999;56:889–895. PubMed

Poortinga W. Social capital: an individual or collective resource for health? Soc. Sci. Med. 2006;62:292–302. PubMed

Radloff L.S. The Center for Epidemiologic Studies Depression Scale: a self-report depression scale for research in the general population. Appl. Psychol. Meas. 1977;1:385–401.

Scholes S., Medina J., Cheshire H., Cox K., Hacker E., Lessof C. NatCen; London: 2009. Living in the 21st Century: Older People in England: the 2006 English Longitudinal Study of Ageing, Technical Report; pp. 1–295.

Stafford M., McMunn A., De Vogli R. Neighbourhood social environment and depressive symptoms in mid-life and beyond. Ageing Soc. 2011;31:893–910.

Steffick D. HRS/AHEAD Documentation Report DR-005; Ann Arbor, MI: 2000. Documentations of Affective Functioning Measures in the Health and Retirement Study.

Steptoe A., Breeze E., Banks J., Nazroo J. Cohort profile: the English longitudinal study of ageing. Int. J. Epidemiol. 2013;42:1640–1648. PubMed PMC

Tufis P. Status attainment in the post-communist transition in central and Eastern Europe. Calitatea Vietii. 2010;22:321–350.

Turvey C.L., Wallace R.B., Herzog R. A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. Int. Psychogeriatr. 1999;11:139–148. PubMed

Weich S., Twigg L., Lewis G. Rural/non-rural differences in rates of common mental disorders in Britain: prospective multilevel cohort study. Br. J. Psychiatry. 2006;188:51–57. PubMed

The Southern European Atlantic diet and depression risk: a European multicohort study

Cross-Sectional and Longitudinal Association between Neighborhood Environment and Perceived Control in Older Adults: Findings from HRS