Prevalence of depression among older adults living in care homes in China: A systematic review and meta-analysis

https://doi.org/10.1016/j.ijnurstu.2021.104114Get rights and content

Abstract

Objectives

Despite the large number of older adults living in care homes in China, the reported prevalence of depression in such settings has varied greatly, while its pooled overall prevalence has remained unknown. In response, our systematic review and meta-analysis were designed to provide accurate, comprehensive evidence of the prevalence of geriatric depression in care homes in China.

Methods

Literature searches were conducted independently by two investigators in English- and Chinese-language databases from database inception through January 2020. The prevalence of depressive symptoms in late life was analyzed with a random effects model.

Results

In 69 studies addressing older adults living in care homes in China, the pooled overall prevalence of depressive symptoms was 36.8% (95% CI, 32.7%–41.1%). Respective estimates for mild and moderate-to-severe depressive symptoms were 29.1% (95% CI, 25.2%–32.7%) and 9.1% (95% CI, 7.5%–11.0%). Subgroup analyses revealed significant differences in the prevalence of late-life depression in care homes according to the type of care home, the individual's socioeconomic status, and the measurement instrument(s) used. Meta-regression analysis indicated that the prevalence of late-life depression among older adults living in care homes generally rose from 1991 to 2019.

Conclusions

Given the high prevalence of geriatric depression in China's care homes, future studies should examine its risk and protective factors in those settings.

Section snippets

What is already known

  • The pooled overall prevalence of depressive symptoms among China's older adults living in care homes ranged from 14.8% to 23.6%.

  • Significant differences in prevalence emerged according to gender, age, and socioeconomic status.

What this paper adds

  • The pooled overall prevalence of depressive symptoms among older adults in care homes in China was 36.8%.

  • As China's government increasingly promoted the development of care homes, the prevalence still rose from 1991 to 2019.

  • The review revealed significant differences in prevalence according to the type of care home, the individual's socioeconomic status, and the measurement instrument(s) used.

Method

Our review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Liberati et al., 2009) and the guidelines of the Meta-Analysis of Observational Studies in Epidemiology (Stroup et al., 2000). It has also been registered at PROSPERO (Registration No. CRD42020190528).

Selection and characteristics of studies

Once duplicates were removed from the initial search results, 30,405 studies remained, and after their titles and/or abstracts were screened, the full texts of 109 studies were retrieved and assessed for eligibility. Of them, 40 studies were discarded according to the inclusion and exclusion criteria. In particular, 27 were duplicates, eight did not report prevalence data or effect size, two studies did not measure depressive symptoms or depressive disorders, one study's sample did not include

Discussion

The pooled overall prevalence of depressive symptoms among older adults living in China's care homes reached 36.8% (95% CI, 32.7%–41.1%), which far exceeds rates reported in a recent systematic review and meta-analysis on the overall prevalence of depressive symptoms among community-dwelling older adults—that is, 20.0% (Tang et al., 2021). Those findings imply that older adults living in China's care homes are at a higher risk of depression than their community-dwelling counterparts, which

Conclusion

Having analyzed 67 studies addressing the prevalence of depressive symptoms among older adults in China's care homes, we identified three major trends. First, the pooled overall prevalence of depressive symptoms among such older adults was 36.8%, which far exceeds the prevalence of geriatric depression reported in previous systematic reviews addressing depressive symptoms among community-dwelling older adults in China. Second, from 1991 to 2019, the prevalence of late-life depression in China's

Declaration of Competing Interest

None.

Acknowledgments

None.

Funding

No external funding.

Data Availability Statement

The authors confirm that the data supporting the findings of this study are available within the article.

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