Background: Rapid urbanization in China, while boosting socioeconomic development, has triggered “radical urbanization” characterized by land expansion outpacing population growth and economic activity. This spatial mismatch manifests as high building vacancy rates and underutilized infrastructure. Although urbanization is linked to mental health outcomes, evidence on radical urbanization’s impact on depression—especially among middle-aged and elderly populations—remains scarce. Methods: This cross-sectional study utilized 2011 baseline data from the China Health and Retirement Longitudinal Study (CHARLS), including 11,126 participants aged ≥45 years. Depressive symptoms were assessed using the CES-D scale (score ≥10 = clinically significant). The radical urbanization index was calculated as the log ratio of city-level built-up area (from China City Statistical Yearbook) to aggregated nighttime light DN values (using thresholds: eastern China ≥34, western China ≥25). Multivariable logistic regression (three adjusted models) and restricted cubic splines evaluated associations. Subgroup analyses and machine learning models (AUC comparison) further validated findings. Results: (1) Radical urbanization index was significantly higher in the depressive symptoms (DS) group vs. non-depressive symptoms (NDS) group (−4.74 vs. −4.96, *p* < 0.001). (2) Each 1-unit increase in the index elevated depression risk by 26% (OR=1.26, 95% CI:1.14–1.38; fully adjusted Model 3). (3) A dose-response relationship emerged: Q4 (highest index) had 1.68 × higher depression risk than Q1 (lowest) (*p*-trend<0.001). (4) Stronger associations occurred in central/western China (e.g., Hunan, Sichuan), low-education groups (OR=1.31), and rural residents (OR=1.30). (5) Adding the index to prediction models improved test-set AUC from 0.649 to 0.663. Conclusion: Radical urbanization—reflecting inefficient land-use and economic-population mismatch—is independently associated with depression among Chinese middle-aged and elderly adults. Findings underscore the need to reorient urbanization policies from “land expansion” to “human-centered” development to mitigate mental health burdens.

Objective: To compare and rank the effects of different mind–body exercise interventions on psychological and physical outcomes in individuals with type 2 diabetes mellitus using a network meta-analysis. Methods: This study systematically searched PubMed, Embase, Web of Science, and the Cochrane Library, and conducted a frequentist network meta-analysis using Stata with SUCRA-based ranking; risk of bias was assessed using RoB 2.0, certainty of evidence evaluated with CINeMA, and robustness examined through sensitivity analyses and publication bias assessment using funnel plots. Results: This study provides preliminary, outcome-specific evidence based on 13 randomized controlled trials involving over 500 individuals with type 2 diabetes mellitus. Network meta-analysis suggested that Pilates significantly improved balance ability (SMD = 1.52, 95% CI 0.77–2.28) and walking ability (SMD = 1.20, 95% CI 0.28–2.12) compared with control. Walking Meditation showed a favorable effect on aerobic capacity (SMD = 1.40, 95% CI 0.44–2.37), while yoga improved muscle strength (SMD = 0.79, 95% CI 0.26–1.33). Mindfulness-based interventions were associated with reduced anxiety (SMD = 1.05, 95% CI 0.46–1.63). Sensitivity analyses indicated that physical function outcomes were generally robust, whereas psychological outcomes were sensitive to influential studies. The certainty of evidence was predominantly very low according to CINeMA assessment. Conclusion: This network meta-analysis provides preliminary, outcome-specific evidence that mind–body exercise may improve physical function in type 2 diabetes, while effects on psychological outcomes remain uncertain and warrant further high-quality research. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ , identifier CRD420251133289.