Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis

Background: To date, the reported prevalence of late-life depression in China has varied considerably, and the pooled overall prevalence of depressive symptoms among older adults in China and the tendency of the rate to change in the past 30 years have remained unknown. Thus, our study was designed to form an accurate and comprehensive picture of the recent prevalence of depressive symptoms among older adults in China. Methods: Literature searches were conducted independently by two investigators in English- and Chineselanguage databases from database inception to January 2020. The prevalence of depressive symptoms was analysed with a random effects model. Results: In the 81 eligible studies (n = 261,697) identified, the pooled overall prevalence of depressive symptoms among older adults in China was 20.0% (95% CI, 17.5%-22.8%), with high heterogeneity, Q = 22,947.0, I2 = 99.7%, p < .001. Subgroup analyses revealed significant differences in the prevalence of late-life depression depending upon gender, marital status, socio-economic status, and measurement scale(s) used. Meta-regression indicated that the prevalence of depressive symptoms among older adults in China increased from the 1990s to the 2000s but slightly decreased from the 2000s to the 2010s. Limitations: Significant heterogeneity among the studies reviewed was unavoidable, and the findings was not generalisable to all regions in China. Conclusions: Depressive symptoms are common among older adults in China, and policies should be developed that consider vulnerable older adults in particular.