Objective neighbourhood attributes as correlates of neighbourhood dissatisfaction and the mediating role of neighbourhood perceptions in older adults from culturally and physically diverse urban environments

Neighbourhood dissatisfaction appears to be detrimental to older adults' health. Understanding associations between objective neighbourhood attributes and neighbourhood satisfaction is important to provide optimal neighbourhood environments for older adults. Comparable data from epidemiological studies conducted in two cities (Hong Kong and Ghent, Belgium) were employed. Generalised additive mixed models were used to examined associations between objectively measured neighbourhood environment attributes and neighbourhood dissatisfaction, mediated by perceived neighbourhood attributes and moderated by city and lower extremity function. All associations between objective neighbourhood attributes and neighbourhood dissatisfaction (total effects) were significant and in the expected direction, six were curvilinear. No moderation by city was observed. With one exception, conceptually-comparable perceived counterparts fully or partially mediated associations between objectively-assessed neighbourhood environment attributes and neighbourhood dissatisfaction. Six of the 10 perceived environment mediated effects of objective environment attributes on neighbourhood dissatisfaction varied by city. Most pertained to differences in strength of associations, rather than significance or direction of associations. Physical functionality did not moderate any of the examined associations. This study suggests that provision of good access to neighbourhood destinations and public transport is important for older adults' neighbourhood satisfaction and, thus, their health.