As the global population continues to age, mental health issues such as depression, anxiety, stress, loneliness, and social isolation among older adults are receiving increasing attention. The built environment is closely associated with older adults’ daily mobility, environmental perception, social participation, and mental health and well-being, but the evidence remains heterogeneous across spatial contexts, environmental indicators, and study designs. Previous umbrella reviews have summarized broad links between the built environment and healthy aging, but less attention has been paid to recent original empirical studies published after the COVID-19 pandemic, the distinction between objective environmental exposure and subjective environmental perception, and the role of social participation as a pathway linking environmental conditions to mental health and well-being. This study employs a systematic literature review approach, searching and screening peer-reviewed empirical studies published between 2015 and January 2026 that focus on the associations between the built environment and older adults’ mental health and well-being. PubMed, Scopus, and Web of Science databases were used for searching, supplemented by manual searching. After title and abstract screening and full-text evaluation, a total of 60 studies were included. Subsequently, a comprehensive analysis was conducted on aspects such as research design, spatial scale, environmental indicators, types of mental health outcomes, and potential pathways of action. In this review, core mental health and well-being outcomes included negative outcomes, such as depression, anxiety, stress, psychological distress, loneliness, and social isolation, and positive outcomes, such as life satisfaction, subjective well-being, psychological well-being, and mental well-being. Social participation was examined as a behavioral and psychosocial pathway rather than as a core outcome. Emerging methods, including street-view image analysis, FCN-based semantic segmentation, and XGBoost-SHAP, were examined because they can refine environmental exposure measurement and support variable-importance interpretation, rather than because they provide causal evidence. The main synthesis suggests that several built environment factors are associated with older adults’ mental health and well-being, although the strength and consistency of evidence vary across outcome types, spatial contexts, and study designs. (1) Exposure to green and blue spaces, quality of public open spaces, walkability and accessibility, accessibility of neighborhood facilities and services, housing and living conditions, and positive environmental perception are mostly associated with lower levels of depression, anxiety, stress, and loneliness, as well as higher levels of life satisfaction, subjective well-being, and psychological well-being. (2) Conversely, adverse environmental exposures such as proximity to roads, pollution, non-vegetated spaces, and high-intensity urbanization are more likely to exacerbate negative psychological outcomes. Existing evidence also suggests that social participation is one of the important behavioral pathways through which the built environment is linked to the mental health of older adults, but it is not the only mechanism. (3) In addition, the direction and intensity of environmental associations remain heterogeneous under different spatial scales, indicator types, and research methods. Overall, this review contributes by organizing recent empirical evidence into a built environment–social participation–mental health and well-being framework, while emphasizing that most findings should be interpreted primarily as evidence of association rather than as stable or uniform causal effects.
Wu et al. (Tue,) studied this question.
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