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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Abstract Full text Figures/Tables Video References Cited by

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

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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. 榮健, 戈艷紅, 孟娜娜, 等. 2010~2019年中國老年人抑郁癥患病率的Meta分析. 中國循證醫學雜志, 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. 羅微, 程鵬. 空巢老人社會參與狀況對其健康狀況的影響. 醫學與社會, 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, 劉曉芳, 楊光, 等. 中國空巢老人抑郁患病率的Meta分析. 中國衛生統計, 2014, 31(2): 278-281.
11. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
12. 吳惠一, 劉穎, 蘭亞佳, 等. 中國絕經女性骨質疏松癥患病率的Meta分析. 中國循證醫學雜志, 2022, 22(8): 882-890.
13. 吳義姣, 張天嬌, 郝無迪, 等. 2013年沈陽市農村老年人抑郁癥狀現狀及其影響因素分析. 實用預防醫學, 2018, 25(7): 773-776.
14. 王志, 沈露潔, 陳晨, 等. 2018年我國≥60歲老年人抑郁情況及影響因素分析. 江蘇預防醫學, 2022, 33(1): 55-57.
15. 榮健, 戈艷紅, 陳貴梅, 等. 安徽省農村老年人抑郁癥狀及影響因素研究. 南京醫科大學學報(社會科學版), 2021, 21(1): 29-35.
16. 韓蕊, 湯哲, 馮明, 等. 北京市城鄉老年人健康狀況分析. 醫學臨床研究, 2013(8): 1457-1460.
17. 劉正奎, 陳天勇, 王金鳳, 等. 城鎮化進程中農村老年人的抑郁情緒及相關因素. 中國心理衛生雜志, 2018, 32(1): 43-48.
18. 譚小林, 趙科, 文晏, 等. 重慶市農村社區老年人抑郁狀況及其影響因素. 中國老年學雜志, 2014(10): 2840-2842.
19. 陳麗, 張婧. 吉安市老年人抑郁狀況及其影響因素. 中國老年學雜志, 2017, 37(24): 6238-6240.
20. 孔憲焜, 肖巧玲, 李娟. 老年抑郁癥狀相關因素的城鄉比較. 中國心理衛生雜志, 2018, 32(8): 648-655.
21. 馮強偉, 王取南, 楊林勝, 等. 六安市城鄉社區老年人抑郁癥狀及其與慢性病的關聯性研究. 現代預防醫學, 2018, 45(20): 3731-3734,3747.
22. 何玲玲, 徐正挺, 徐傳雁. 內蒙古自治區巴彥淖爾市農村中老年人砷中毒與抑郁的關系. 中華地方病學雜志, 2022, 41(1): 32-35.
23. 白濤, 武麗, 姜雪錦, 等. 農村地區老年人社會支持與抑郁關系. 中國公共衛生, 2012, 28(8): 1044-1048.
24. 崔雪巖, 李鳳琴, 張金華, 等. 農村老年人運動障礙綜合征與閾下抑郁現狀及其相關性分析. 護理研究, 2021, 35(12): 2106-2110.
25. 魏映紅, 曾耀群, 許曉飛. 清遠市農村社區老年人抑郁狀態的調查與分析. 清遠職業技術學院學報, 2016, 9(3): 26-29.
26. 李彥章, 匡婭. 四川城鄉老年人抑郁比較. 中國老年學雜志, 2017, 37(4): 979-980.
27. 張惠, 戴冰. 四川地區家庭養老模式下老年人抑郁狀況. 中國老年學雜志, 2012, 32(16): 3494-3495.
28. 王麗, 張曉. 我國農村老年人抑郁癥狀性別差異及影響因素研究. 中華疾病控制雜志, 2018, 22(11): 1148-1151.
29. 陳羽保, 郭飏, 付雪連, 等. 湘潭地區農村老年人健康現況調查分析. 全科護理, 2020, 18(11): 1394-1397.
30. 楊家甜. 云南寧洱縣不同社會經濟地位老年人的抑郁狀況及對生命質量的影響研究. 昆明: 昆明醫科大學, 2020.
31. 楊展, 陳饒, 胡曉, 等. 中國城鄉老年人抑郁癥狀及其影響因素差異的分析. 中華流行病學雜志, 2017, 38(8): 1088-1093.
32. 劉丹丹, 劉習羽, 劉慧敏, 等. 中國農村老年人抑郁現狀及影響因素分析. 鄭州大學學報(醫學版), 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. 聶曉璐, 王紅英, 孫鳳, 等. 2000-2012年中國社區人群老年期抑郁情緒檢出率—系統綜述和更新的meta分析. 中國心理衛生雜志, 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. 簡版老年抑郁量表(GDS-15)在中國老年人中的使用. 中國臨床心理學雜志, 2013, 21(3): 402-405.
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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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