Role of age-friendly communities on the association between informal caregiving and depressive symptoms: a multilevel analysis using the Japan Gerontological Evaluation Study

Background and ObjectivesAge-friendly communities (AFC) are inclusive and accessible community environments that ensure older adults quality of life and dignity. However, empirical evidence regarding the AFC influence on informal caregivers is lacking. This study examined the moderating role of AFC on the association between caregiving and depressive symptoms. Research Design and MethodsThis cross-sectional study included 10,315 older adults (mean 74.2 years) across 145 communities from the Japan Gerontological Evaluation Study 2016 data. Participants were divided based on providing care to families: "not caregivers" and "caregivers." The AFC scale assessed community-level age-friendliness in three domains: age-friendly physical environments (accessibility to barrier-free outdoor spaces, buildings, and transportation), social engagement and communication (participation in community groups, volunteer engagement, and information use), and social inclusion and dementia- friendliness (respect and inclusion for older adults and people with dementia). The multilevel analysis with individuals nested in communities examined the cross-level interactions of caregiving and community-level age-friendliness on depressive symptoms assessed using the Geriatrics Depression Scale-15. ResultsAmong the participants, 7.1% were caregivers. Caregiving was associated with higher depressive symptoms. Of the AFC scale, the social inclusion and dementia-friendliness domain moderated the association between caregiving and depressive symptoms, whereas the social engagement and communication domain amplified this association. The age-friendly physical environment domain showed no modifications. Discussion and ImplicationsInclusive and dementia-friendly aspects of AFC potentially moderate the caregivers depressive symptoms. However, the communitys physical environment and social interaction elements may not relate to caregivers mental benefits. These findings underscore the AFC promotion considering caregivers.