Correlates of Depressive Symptoms in Rural Elderly Chinese

Objective: Late life depression has been studied in many populations around the world. However, findings on risk factors for late life depression have remained inconsistent.

Methods: A cross-sectional survey of 1737 rural Chinese age 65 and over from two provinces in China was conducted assessing cognitive functions using various cognitive instruments and collecting information on demographic characteristics and medical history. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Analysis of covariance and logistic regression models were used to identify factors associated with the continuous GDS score, mild or severe depression.

Results: In this cohort, 26.5% (95% CI: 24.4-28.6%) met the criteria for mild depression and 4.3% (95% CI: 3.4-5.4%) for severely depression. Living alone, history of heart attack, head injury, and fracture were associated with higher depressive symptoms. Alcohol consumption and higher cognitive function were associated with lower depressive symptoms. Living alone, not attended school, history of head injury, fracture, and low cognitive function were associated with increased probability of mild depression. Living alone, history of stroke or heart attack, and low cognitive function were associated with severe depression.

Conclusions: Depression, particularly mild depression, is common in rural elderly Chinese. Among a number of factors identified in this cohort as being significantly associated with depressive symptoms, living alone and lower cognitive function were the most consistent factors associated with depressive symptoms, mild and severe depression. History of stroke, heart attack, and fracture were also risk factors for depressive symptoms.