Quality of accommodation and risk of depression in later life: an analysis of prospective data from the Gospel Oak Project

Objective: To investigate the association between observer-rated quality of internal accommodation and risk of onset of depression.

Design: A secondary analysis of data from a cross-sectional survey of residents aged 65 or over in a north London electoral ward who were followed up after a one-year interval.

Method: Pervasive depression (SHORT-CARE) was assessed at both interviews. Quality of accommodation (on a five-point scale) was assessed by a single interviewer in a random sample at baseline. Potential confounding factors which were considered included age, sex, social class, level of handicap, level of social support, baseline sub-case depressive symptoms, cognitive function, income, accommodation tenure and area-level housing quality.

Results: In participants without depression at baseline (n=131), worse accommodation was associated with depression after one year (odds ratio (OR) between three accommodation groups 3.3, 95% confidence intervals (CI) 1.5-7.8). Adjustment for the potential confounding factors made little difference (adjusted OR 3.3). The association was principally in people cohabiting (OR 12.4) rather than living alone (OR 1.1).

Conclusions: An observer's impression of accommodation quality was a strong and independent predictor of depression in this sample. The stronger association in people who were cohabiting may reflect increased exposure to the internal environment.