Green space associations with mental health and cognitive function: Results from the Quebec CARTaGENE cohort

Abstract

Background: Urban green space may be important to mental health, but the association between long-term green space exposures and depression, anxiety, and cognitive function in adults remains unknown. Methods: We examined 8,144 adults enrolled in the CARTaGENE cohort in Quebec Canada. Average green space and change in green space with residential mobility were assessed using satellite-derived normalized difference vegetation index from 5-year residential address histories. Outcomes included depression and anxiety determined through medical record linkages, self-reported doctor diagnosis of depression, and the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7scales. Cognitive function was available for 6,658 individuals from computerized tests of reaction time, working memory, and executive function. We used linear and logistic multivariate models to assess associations between green space and each mental health and cognitive function measure. Results: In fully adjusted analyses, a 0.1 increase in residential normalized difference vegetation index within 500 m was associated with an odds ratio of 0.85 (95% CI: 0.76, 0.95) for a self-reported doctor diagnosis of depression and 0.81 (95% CI: 0.70, 0.93) for moderate anxiety assessed using the Generalized Anxiety Disorder 7 scale. Other models showed protective effects of urban green space on depression and anxiety but were not statistically significant, and the magnitude of association varied by green space exposure and mental health outcome assessment method. We did not observe any evidence of associations between green space and cognitive function. Conclusions: We observed some evidence to support the hypothesis that urban green space is associated with decreased depression and anxiety but not cognitive function.