Periodic Reporting for period 3 - MINDMAP (PROMOTING MENTAL WELLBEING IN THE AGEING URBAN POPULATION: DETERMINANTS, POLICIES AND INTERVENTIONS IN EUROPEAN CITIES)
Período documentado: 2019-01-01 hasta 2020-06-30
Major depressive disorder, dementia, anxiety disorders, and substance abuse affect a substantial part of the European older population. Over 70% of Europeans reside in cities, and this percentage will increase in the next decades. Urbanization and ageing have enormous implications for public mental health. While cities pose major challenges for older citizens, they also offer unique opportunities for the design of policies and clinical and public health interventions that promote mental health and ensure the delivery of health care services for the old. The MINDMAP project started in 2016 and aims to identify the opportunities offered by the urban environment for the promotion of mental wellbeing and cognitive function of older individuals in Europe.
We brought together longitudinal studies across cities in Europe and Canada and enriched them with information on urban characteristics and policies. This enriched set of data allows us to unravel the causal pathways and multi-level interactions between the urban environment and the social, behavioural, psychosocial and biological determinants of mental health and cognitive function in older adults. Specifically, MINDMAP aimed to (a) assess the impact of the urban environment on the mental wellbeing and disorders associated with ageing, and estimate the extent to which exposure to specific urban environmental factors and policies explain differences in ageing-related mental and cognitive disorders both within as well as between cities, (b) assess the causal pathways and interactions between the urban environment and the individual factors affecting mental health and cognitive ageing in older adults, (c) use agent-based modelling to simulate the effect of urban environmental, prevention and care policies on the trajectories of mental health and cognitive ageing across cities in Europe. Our knowledge may significantly contribute to future-proof preventive strategies in urban settings favouring the mental dimension of healthy ageing, the reduction of the negative impact of mental disorders on co-morbidities, and maintaining cognitive ability in old age.
We brought together longitudinal studies across cities in Europe and Canada and enriched them with information on urban characteristics and policies. This enriched set of data allows us to unravel the causal pathways and multi-level interactions between the urban environment and the social, behavioural, psychosocial and biological determinants of mental health and cognitive function in older adults. Specifically, MINDMAP aimed to (a) assess the impact of the urban environment on the mental wellbeing and disorders associated with ageing, and estimate the extent to which exposure to specific urban environmental factors and policies explain differences in ageing-related mental and cognitive disorders both within as well as between cities, (b) assess the causal pathways and interactions between the urban environment and the individual factors affecting mental health and cognitive ageing in older adults, (c) use agent-based modelling to simulate the effect of urban environmental, prevention and care policies on the trajectories of mental health and cognitive ageing across cities in Europe. Our knowledge may significantly contribute to future-proof preventive strategies in urban settings favouring the mental dimension of healthy ageing, the reduction of the negative impact of mental disorders on co-morbidities, and maintaining cognitive ability in old age.
MINDAP reconsidered the theory, concepts and mechanisms underling the link between the physical and social urban environment. A return to theory, preferably from different research fields, may strengthen the design of empirical studies and allow for a better understanding of (inconsistent) findings. Although different sources of data collection were used (including data registries), the core of the project consisted of the construction of a data infrastructure allowing unique analyses of the relation between environmental characteristics and mental wellbeing and intermediary variables across cities. Following the GDPR, which was implemented around the start of the MINDMAP project, the integrated database infrastructure was filled with harmonized data. Empirical analyses were done on datasets in which urban environmental factors were linked to individual behavioural and mental health outcomes. We also investigated the contribution of variables on the causal pathways, and the moderating of role of urbanicity in the association between individual variables and mental health outcomes. Furthermore, the impact of ageing-related social policies was investigated for mental wellbeing of older persons. Agent-based models were developed illustrating how (urban) policies can influence mental wellbeing of older adults, according to a systems approach. All work packages were involved in training activities to share findings of the study with (local) stakeholders. Multiple dissemination activities, at local, national and European level, were undertaken to share these new insights with fellow researchers across fields, policy makers, professionals and politicians. These activities include scientific publications in high impact journals, presentations at national and international conferences and discussions and workshops with interdisciplinary stakeholders.
Annual project board meetings were organised, of which one was a online meeting after the start of the COVID-19 pandemic. Working group meetings were held on overarching themes, most intensively concerning the harmonisation of the data in the platform. Numerous bilateral meetings were held.
By the end of the project, approximately 50 peer-reviewed international publications were published from the project, and still many papers are under review or in preparation. A special issue of the Journal of Community Health and Epidemiology is devoted to the MINDMAP project.
MINDMAP has produced a substantial amount of new information on a theme that is probably even more important than it was at the start of the project: a healthy urban living environment for older persons. The data infrastructure realised in the project is an important legacy of the project, which allows much further work.
Annual project board meetings were organised, of which one was a online meeting after the start of the COVID-19 pandemic. Working group meetings were held on overarching themes, most intensively concerning the harmonisation of the data in the platform. Numerous bilateral meetings were held.
By the end of the project, approximately 50 peer-reviewed international publications were published from the project, and still many papers are under review or in preparation. A special issue of the Journal of Community Health and Epidemiology is devoted to the MINDMAP project.
MINDMAP has produced a substantial amount of new information on a theme that is probably even more important than it was at the start of the project: a healthy urban living environment for older persons. The data infrastructure realised in the project is an important legacy of the project, which allows much further work.
The MINDMAP project improved the understanding, prevention and early diagnosis of mental well being and disorders of older people. Initially and paradoxically, the linkage of urban characteristics to health and wellbeing was often restricted to a single city; MINDMAP brought cities together, and allowed to optimally use the variation in urban and health contexts within and between cities. Whereas the majority of studies in this research field used a cross-sectional design, the project emphasized the importance of an approach that comes closer to causal interpretations of findings, and to solutions in policy and practice. Evaluating the impact of policies showed that those that promote social participation offer promise to improve mental wellbeing of older persons. That urban physical circumstances may facilitate social participation adds to the growing recognition that urban characteristics act together, and that a systems perspective is important in order to answer policy relevant questions.