Participation in gardening activity and its association with improved mental health among family caregivers of people with dementia in rural Uganda

•Family caregivers of people living with dementia experience high levels of anxiety and stress.•Participating in gardening is associated with lower symptoms of depression, anxiety and stress.•These findings may provide insights into future gardening intervention trials. Evidence from high-income settings suggests that gardening is associated with reductions in depression,anxiety,and stress. The benefits of gardening are less well understood by mental health practitioners andresearchers from low- and middle-income countries. Our study estimated the association between participation in gardening and symptoms of depression, anxiety, and stress among caregivers of people living with dementia in rural, southwestern Uganda. In a cross-sectional study, we interviewed 242 family caregivers of people with dementia to elicit their gardening activities; symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scales); and caregiving burden (Zarit Burden Interview).Linear multivariable regression models estimated the association between participation in gardening and symptoms of depression, anxiety, and stress. Out of 242participants, 131(54%) caregivers were involved in gardening. Severe to extremely severe symptoms of depression were less prevalent among those who were involved in gardening compared with those who were not (0 [0%] vs. 105 [95%], P