Prevalence of depression among elderly populations in rural China: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Pengfei ^1,2 , YANG Xiaoguang ¹ , LU Qiang ¹ , YAN Ya ¹ , PEI Jiaxing ^1,2 ,  LI Yunming ^1,2

1. Department of Information, Medical Support Center, the General Hospital of Western Theater Command, Chengdu 610083, P. R. China;
2. School of Public Health, Southwest Medical University, Luzhou 646000, P. R. China;

Corresponding author：

LI Yunming, Email: lee3082@sina.com

Keywords：

Depression; Elderly; Rural; Meta-analysis; Systematic review; Prevalence

DOI：

10.7507/1672-2531.202304113

Video：

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Objective To systematically review the prevalence of depression in rural Chinese population aged 60 and above from 2010 to 2023. Methods The CNKI、WanFang Data、VIP、CBM、PubMed、Embase and Cochrane Library databases were electronically searched to collect cross-sectional studies on the prevalence of depression of elderly populations in rural China from January 2010 to March 2023. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 17.0 software. Results A total of 23 cross-sectional studies with a total sample of 34 916 cases and 11 308 depression patients were included. The meta-analysis results showed that the prevalence of depression in rural Chinese population was 31.02% (95%CI 26.10% to 36.16%). Subgroup analysis showed that the prevalence was higher among females than males; the GDS-30 scale had the highest detection rate, followed by the CES-D-10 and GDS-15 scales; the prevalence was higher in the Midwest than in the East; and the prevalence was higher in surveys conducted after 2015 than in 2015 and before. In addition, the prevalence of depression was higher in the rural elderly population aged 70 and above, non-married, illiterate or semi-literate, with poor self-rated health status, living alone, in poor economic status, with chronic diseases, and with low social activity. Conclusion The prevalence of depression is high among the rural elderly population in China, and there are significant disparities in the prevalence of different characteristics of the elderly. These differences should be given more attention to improve the mental health of the rural elderly population. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： ZHOU Pengfei, YANG Xiaoguang, LU Qiang, YAN Ya, PEI Jiaxing, LI Yunming. Prevalence of depression among elderly populations in rural China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2024, 24(1): 36-42. doi: 10.7507/1672-2531.202304113 Copy

1.	Akimov AV, Gemueva KA, Semenova NK. The seventh population census in the prc: results and prospects of the country's demographic development. Her Russ Acad Sci, 2021, 91(6): 724-735.
2.	Guo C, Zheng X. Health challenges and opportunities for an aging China. Am J Public Health, 2018, 108(7): 890-892.
3.	Bi YH, Pei JJ, Hao C, et al. The relationship between chronic diseases and depression in middle-aged and older adults: a 4-year follow-up study from the China Health and Retirement Longitudinal Study. J Affect Disord, 2021, 289: 160-166,289-160.
4.	Ren X, Yu S, Dong W, et al. Burden of depression in China, 1990-2017: findings from the global burden of disease study 2017. J Affect Disord, 2020, 268: 95-101.
5.	荣健, 戈艳红, 孟娜娜, 等. 2010~2019年中国老年人抑郁症患病率的Meta分析. 中国循证医学杂志, 2020, 20(1): 26-31.
6.	Fu X, Su Y, Zeng C, et al. The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: a cross-sectional survey. Front Public Health, 2022, 10: 942311.
7.	Xu R, Liu Y, Mu T, et al. Determining the association between different living arrangements and depressive symptoms among over-65-year-old people: the moderating role of outdoor activities. Front Public Health, 2022, 10: 954416.
8.	罗微, 程鹏. 空巢老人社会参与状况对其健康状况的影响. 医学与社会, 2023, 36(4): 37-42.
9.	Zhang HH, Jiang YY, Rao WW, et al. Prevalence of depression among empty-nest elderly in China: a meta-analysis of observational studies. Front Psychiatry, 2020, 11: 608.
10.	辛菲, 刘晓芳, 杨光, 等. 中国空巢老人抑郁患病率的Meta分析. 中国卫生统计, 2014, 31(2): 278-281.
11.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
12.	吴惠一, 刘颖, 兰亚佳, 等. 中国绝经女性骨质疏松症患病率的Meta分析. 中国循证医学杂志, 2022, 22(8): 882-890.
13.	吴义姣, 张天娇, 郝无迪, 等. 2013年沈阳市农村老年人抑郁症状现状及其影响因素分析. 实用预防医学, 2018, 25(7): 773-776.
14.	王志, 沈露洁, 陈晨, 等. 2018年我国≥60岁老年人抑郁情况及影响因素分析. 江苏预防医学, 2022, 33(1): 55-57.
15.	荣健, 戈艳红, 陈贵梅, 等. 安徽省农村老年人抑郁症状及影响因素研究. 南京医科大学学报(社会科学版), 2021, 21(1): 29-35.
16.	韩蕊, 汤哲, 冯明, 等. 北京市城乡老年人健康状况分析. 医学临床研究, 2013(8): 1457-1460.
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18.	谭小林, 赵科, 文晏, 等. 重庆市农村社区老年人抑郁状况及其影响因素. 中国老年学杂志, 2014(10): 2840-2842.
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20.	孔宪焜, 肖巧玲, 李娟. 老年抑郁症状相关因素的城乡比较. 中国心理卫生杂志, 2018, 32(8): 648-655.
21.	冯强伟, 王取南, 杨林胜, 等. 六安市城乡社区老年人抑郁症状及其与慢性病的关联性研究. 现代预防医学, 2018, 45(20): 3731-3734,3747.
22.	何玲玲, 徐正挺, 徐传雁. 内蒙古自治区巴彦淖尔市农村中老年人砷中毒与抑郁的关系. 中华地方病学杂志, 2022, 41(1): 32-35.
23.	白涛, 武丽, 姜雪锦, 等. 农村地区老年人社会支持与抑郁关系. 中国公共卫生, 2012, 28(8): 1044-1048.
24.	崔雪岩, 李凤琴, 张金华, 等. 农村老年人运动障碍综合征与阈下抑郁现状及其相关性分析. 护理研究, 2021, 35(12): 2106-2110.
25.	魏映红, 曾耀群, 许晓飞. 清远市农村社区老年人抑郁状态的调查与分析. 清远职业技术学院学报, 2016, 9(3): 26-29.
26.	李彦章, 匡娅. 四川城乡老年人抑郁比较. 中国老年学杂志, 2017, 37(4): 979-980.
27.	张惠, 戴冰. 四川地区家庭养老模式下老年人抑郁状况. 中国老年学杂志, 2012, 32(16): 3494-3495.
28.	王丽, 张晓. 我国农村老年人抑郁症状性别差异及影响因素研究. 中华疾病控制杂志, 2018, 22(11): 1148-1151.
29.	陈羽保, 郭飏, 付雪连, 等. 湘潭地区农村老年人健康现况调查分析. 全科护理, 2020, 18(11): 1394-1397.
30.	杨家甜. 云南宁洱县不同社会经济地位老年人的抑郁状况及对生命质量的影响研究. 昆明: 昆明医科大学, 2020.
31.	杨展, 陈饶, 胡晓, 等. 中国城乡老年人抑郁症状及其影响因素差异的分析. 中华流行病学杂志, 2017, 38(8): 1088-1093.
32.	刘丹丹, 刘习羽, 刘慧敏, 等. 中国农村老年人抑郁现状及影响因素分析. 郑州大学学报(医学版), 2021, 56(5): 648-652.
33.	Cheng P, Jin Y, Sun H, et al. Disparities in prevalence and risk indicators of loneliness between rural empty nest and non-empty nest older adults in Chizhou, China. Geriatr Gerontol Int, 2015, 15(3): 356-364.
34.	She R, Yan Z, Jiang H, et al. Multimorbidity and health-related quality of life in old age: role of functional dependence and depressive symptoms. J Am Med Dir Assoc, 2019, 20(9): 1143-1149.
35.	Gong F, Zhao D, Zhao Y, et al. The factors associated with geriatric depression in rural China: stratified by household structure. Psychol Health Med, 2018, 23(5): 593-603.
36.	Li D, Zhang DJ, Shao JJ, et al. A meta-analysis of the prevalence of depressive symptoms in Chinese older adults. Arch Gerontol Geriatr, 2014, 58(1): 1-9.
37.	聂晓璐, 王红英, 孙凤, 等. 2000-2012年中国社区人群老年期抑郁情绪检出率—系统综述和更新的meta分析. 中国心理卫生杂志, 2013, 27(11): 805-814.
38.	Fang M, Mirutse G, Guo L, et al. Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study. BMJ Open, 2019, 9(5): e024046.
39.	Ng C, Tan W, Gunapal P, et al. Association of socioeconomic status (SES) and social support with depressive symptoms among the elderly in Singapore. Ann Acad Med Singap, 2014, 43(12): 576-587.
40.	Yang F, Li Z, Wang GW, et al. Cognitive function and its influencing factors in empty-nest elderly and non-empty-nest elderly adults in China. Aging (Albany NY), 2021, 13(3): 4552-4563.
41.	Wang C, Wang Y, Hu L, et al. The causal association between empty nest and depressive symptoms with cognitive impairments in China. J Affect Disord, 2022, 315: 7-12, 315-317.
42.	Zhang C, Xue Y, Zhao H, et al. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China. J Affect Disord, 2019, 245: 750-756.
43.	Huang F, Wang H, Wang Z, et al. Is geriatric depression scale a valid instrument to screen depression in Chinese community-dwelling elderly. BMC Geriatr, 2021, 21(1): 310.
44.	Krishnamoorthy Y, Rajaa S, Rehman T. Diagnostic accuracy of various forms of geriatric depression scale for screening of depression among older adults: systematic review and meta-analysis. Arch Gerontol Geriatr, 2020, 87: 104002.
45.	Wancata J, Alexandrowicz R, Marquart B, et al. The criterion validity of the geriatric depression scale: a systematic review. Acta Psychiatr Scand, 2006, 114(6): 398-410.
46.	唐丹. 简版老年抑郁量表(GDS-15)在中国老年人中的使用. 中国临床心理学杂志, 2013, 21(3): 402-405.
47.	Boylan JM, Robert SA. Neighborhood SES is particularly important to the cardiovascular health of low SES individuals. Soc Sci Med, 2017, 188: 60-68.
48.	Liu H, Fan X, Luo H, et al. Comparison of depressive symptoms and its influencing factors among the elderly in urban and rural areas: evidence from the China Health and Retirement Longitudinal Study (CHARLS). Int J Environ Res Public Health, 2021, 18(8): 3886.
49.	徐海波, 黄水平, 刘欣, 等. 独居老人抑郁状况与社会支持影响. 中国老年学杂志, 2015, 35(5): 1383-1384.
50.	李翠翠, 江珊, 杨婷婷, 等. 山东省城乡空巢独居老人抑郁状况及影响因素. 中国公共卫生, 2015, 31(12): 1587-1589.
51.	Zhou M, Sun X, Huang L. Chronic disease and medical spending of Chinese elderly in rural region. Int J Qual Health Care, 2021, 33(1): mzaa142.
52.	Glass TA, De Leon CF, Bassuk SS, et al. Social engagement and depressive symptoms in late life: longitudinal findings. J Aging Health, 2006, 18(4): 604-628.
53.	Choi Y, Park EC, Kim JH, et al. A change in social activity and depression among Koreans aged 45 years and more: analysis of the Korean Longitudinal Study of Aging (2006-2010). Int Psychogeriatr, 2015, 27(4): 629-637.
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1. Akimov AV, Gemueva KA, Semenova NK. The seventh population census in the prc: results and prospects of the country's demographic development. Her Russ Acad Sci, 2021, 91(6): 724-735.
2. Guo C, Zheng X. Health challenges and opportunities for an aging China. Am J Public Health, 2018, 108(7): 890-892.
3. Bi YH, Pei JJ, Hao C, et al. The relationship between chronic diseases and depression in middle-aged and older adults: a 4-year follow-up study from the China Health and Retirement Longitudinal Study. J Affect Disord, 2021, 289: 160-166,289-160.
4. Ren X, Yu S, Dong W, et al. Burden of depression in China, 1990-2017: findings from the global burden of disease study 2017. J Affect Disord, 2020, 268: 95-101.
5. 荣健, 戈艳红, 孟娜娜, 等. 2010~2019年中国老年人抑郁症患病率的Meta分析. 中国循证医学杂志, 2020, 20(1): 26-31.
6. Fu X, Su Y, Zeng C, et al. The mediation and interaction of depressive symptoms in activities of daily living and active aging in rural elderly: a cross-sectional survey. Front Public Health, 2022, 10: 942311.
7. Xu R, Liu Y, Mu T, et al. Determining the association between different living arrangements and depressive symptoms among over-65-year-old people: the moderating role of outdoor activities. Front Public Health, 2022, 10: 954416.
8. 罗微, 程鹏. 空巢老人社会参与状况对其健康状况的影响. 医学与社会, 2023, 36(4): 37-42.
9. Zhang HH, Jiang YY, Rao WW, et al. Prevalence of depression among empty-nest elderly in China: a meta-analysis of observational studies. Front Psychiatry, 2020, 11: 608.
10. 辛菲, 刘晓芳, 杨光, 等. 中国空巢老人抑郁患病率的Meta分析. 中国卫生统计, 2014, 31(2): 278-281.
11. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
12. 吴惠一, 刘颖, 兰亚佳, 等. 中国绝经女性骨质疏松症患病率的Meta分析. 中国循证医学杂志, 2022, 22(8): 882-890.
13. 吴义姣, 张天娇, 郝无迪, 等. 2013年沈阳市农村老年人抑郁症状现状及其影响因素分析. 实用预防医学, 2018, 25(7): 773-776.
14. 王志, 沈露洁, 陈晨, 等. 2018年我国≥60岁老年人抑郁情况及影响因素分析. 江苏预防医学, 2022, 33(1): 55-57.
15. 荣健, 戈艳红, 陈贵梅, 等. 安徽省农村老年人抑郁症状及影响因素研究. 南京医科大学学报(社会科学版), 2021, 21(1): 29-35.
16. 韩蕊, 汤哲, 冯明, 等. 北京市城乡老年人健康状况分析. 医学临床研究, 2013(8): 1457-1460.
17. 刘正奎, 陈天勇, 王金凤, 等. 城镇化进程中农村老年人的抑郁情绪及相关因素. 中国心理卫生杂志, 2018, 32(1): 43-48.
18. 谭小林, 赵科, 文晏, 等. 重庆市农村社区老年人抑郁状况及其影响因素. 中国老年学杂志, 2014(10): 2840-2842.
19. 陈丽, 张婧. 吉安市老年人抑郁状况及其影响因素. 中国老年学杂志, 2017, 37(24): 6238-6240.
20. 孔宪焜, 肖巧玲, 李娟. 老年抑郁症状相关因素的城乡比较. 中国心理卫生杂志, 2018, 32(8): 648-655.
21. 冯强伟, 王取南, 杨林胜, 等. 六安市城乡社区老年人抑郁症状及其与慢性病的关联性研究. 现代预防医学, 2018, 45(20): 3731-3734,3747.
22. 何玲玲, 徐正挺, 徐传雁. 内蒙古自治区巴彦淖尔市农村中老年人砷中毒与抑郁的关系. 中华地方病学杂志, 2022, 41(1): 32-35.
23. 白涛, 武丽, 姜雪锦, 等. 农村地区老年人社会支持与抑郁关系. 中国公共卫生, 2012, 28(8): 1044-1048.
24. 崔雪岩, 李凤琴, 张金华, 等. 农村老年人运动障碍综合征与阈下抑郁现状及其相关性分析. 护理研究, 2021, 35(12): 2106-2110.
25. 魏映红, 曾耀群, 许晓飞. 清远市农村社区老年人抑郁状态的调查与分析. 清远职业技术学院学报, 2016, 9(3): 26-29.
26. 李彦章, 匡娅. 四川城乡老年人抑郁比较. 中国老年学杂志, 2017, 37(4): 979-980.
27. 张惠, 戴冰. 四川地区家庭养老模式下老年人抑郁状况. 中国老年学杂志, 2012, 32(16): 3494-3495.
28. 王丽, 张晓. 我国农村老年人抑郁症状性别差异及影响因素研究. 中华疾病控制杂志, 2018, 22(11): 1148-1151.
29. 陈羽保, 郭飏, 付雪连, 等. 湘潭地区农村老年人健康现况调查分析. 全科护理, 2020, 18(11): 1394-1397.
30. 杨家甜. 云南宁洱县不同社会经济地位老年人的抑郁状况及对生命质量的影响研究. 昆明: 昆明医科大学, 2020.
31. 杨展, 陈饶, 胡晓, 等. 中国城乡老年人抑郁症状及其影响因素差异的分析. 中华流行病学杂志, 2017, 38(8): 1088-1093.
32. 刘丹丹, 刘习羽, 刘慧敏, 等. 中国农村老年人抑郁现状及影响因素分析. 郑州大学学报(医学版), 2021, 56(5): 648-652.
33. Cheng P, Jin Y, Sun H, et al. Disparities in prevalence and risk indicators of loneliness between rural empty nest and non-empty nest older adults in Chizhou, China. Geriatr Gerontol Int, 2015, 15(3): 356-364.
34. She R, Yan Z, Jiang H, et al. Multimorbidity and health-related quality of life in old age: role of functional dependence and depressive symptoms. J Am Med Dir Assoc, 2019, 20(9): 1143-1149.
35. Gong F, Zhao D, Zhao Y, et al. The factors associated with geriatric depression in rural China: stratified by household structure. Psychol Health Med, 2018, 23(5): 593-603.
36. Li D, Zhang DJ, Shao JJ, et al. A meta-analysis of the prevalence of depressive symptoms in Chinese older adults. Arch Gerontol Geriatr, 2014, 58(1): 1-9.
37. 聂晓璐, 王红英, 孙凤, 等. 2000-2012年中国社区人群老年期抑郁情绪检出率—系统综述和更新的meta分析. 中国心理卫生杂志, 2013, 27(11): 805-814.
38. Fang M, Mirutse G, Guo L, et al. Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study. BMJ Open, 2019, 9(5): e024046.
39. Ng C, Tan W, Gunapal P, et al. Association of socioeconomic status (SES) and social support with depressive symptoms among the elderly in Singapore. Ann Acad Med Singap, 2014, 43(12): 576-587.
40. Yang F, Li Z, Wang GW, et al. Cognitive function and its influencing factors in empty-nest elderly and non-empty-nest elderly adults in China. Aging (Albany NY), 2021, 13(3): 4552-4563.
41. Wang C, Wang Y, Hu L, et al. The causal association between empty nest and depressive symptoms with cognitive impairments in China. J Affect Disord, 2022, 315: 7-12, 315-317.
42. Zhang C, Xue Y, Zhao H, et al. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China. J Affect Disord, 2019, 245: 750-756.
43. Huang F, Wang H, Wang Z, et al. Is geriatric depression scale a valid instrument to screen depression in Chinese community-dwelling elderly. BMC Geriatr, 2021, 21(1): 310.
44. Krishnamoorthy Y, Rajaa S, Rehman T. Diagnostic accuracy of various forms of geriatric depression scale for screening of depression among older adults: systematic review and meta-analysis. Arch Gerontol Geriatr, 2020, 87: 104002.
45. Wancata J, Alexandrowicz R, Marquart B, et al. The criterion validity of the geriatric depression scale: a systematic review. Acta Psychiatr Scand, 2006, 114(6): 398-410.
46. 唐丹. 简版老年抑郁量表(GDS-15)在中国老年人中的使用. 中国临床心理学杂志, 2013, 21(3): 402-405.
47. Boylan JM, Robert SA. Neighborhood SES is particularly important to the cardiovascular health of low SES individuals. Soc Sci Med, 2017, 188: 60-68.
48. Liu H, Fan X, Luo H, et al. Comparison of depressive symptoms and its influencing factors among the elderly in urban and rural areas: evidence from the China Health and Retirement Longitudinal Study (CHARLS). Int J Environ Res Public Health, 2021, 18(8): 3886.
49. 徐海波, 黄水平, 刘欣, 等. 独居老人抑郁状况与社会支持影响. 中国老年学杂志, 2015, 35(5): 1383-1384.
50. 李翠翠, 江珊, 杨婷婷, 等. 山东省城乡空巢独居老人抑郁状况及影响因素. 中国公共卫生, 2015, 31(12): 1587-1589.
51. Zhou M, Sun X, Huang L. Chronic disease and medical spending of Chinese elderly in rural region. Int J Qual Health Care, 2021, 33(1): mzaa142.
52. Glass TA, De Leon CF, Bassuk SS, et al. Social engagement and depressive symptoms in late life: longitudinal findings. J Aging Health, 2006, 18(4): 604-628.
53. Choi Y, Park EC, Kim JH, et al. A change in social activity and depression among Koreans aged 45 years and more: analysis of the Korean Longitudinal Study of Aging (2006-2010). Int Psychogeriatr, 2015, 27(4): 629-637.
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Chinese Journal of Evidence-Based Medicine

Prevalence of depression among elderly populations in rural China: a meta-analysis

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