Differences in depression prevalence among older adults in China before and during the COVID-19 pandemic: a systematic review and meta-analysis.

OBJECTIVE

Changes in the prevalence of depression during the COVID-19 (Coronavirus disease 2019) pandemic among older adults in China have not been systematically evaluated. We aimed to systematically summarize existing evidence to conduct a meta-analysis to quantify changes in the prevalence of depression before and during the COVID-19 pandemic.

METHODS

The PubMed, Web of Science, Scopus, Embase, PsycINFO, China National Knowledge Infrastructure (CNKI), WangFang Data, CQVIP, and China Biology Medicine disc (CBMdisc) databases were searched from January 1, 2017, to November 20, 2024. Studies reporting the prevalence of depression among Chinese individuals aged 60 or older using validated diagnostic tools were included. A random-effects model was applied to estimate pooled prevalence, with subgroup analyses performed by demographic and socio-economic factors. Relative risks (RR) were calculated to compare prevalence across different pandemic stages.

RESULTS

A total of 101 studies involving 264,758 participants were included. The pooled prevalence of depression among older adults was 25.8% (95% CI [21.7-29.9]) from 2017-2019 and 23.8% (95% CI [19.8-27.8]) from 2020-2023. During the early pandemic stage (January-April 2020), prevalence significantly decreased (RR = 0.849,  < .001) but increased in later stages, reaching 24.4% by 2021-2023. The prevalence of depression among older adults during the COVID-19 pandemic showed a significant increasing trend (  < .001). Subgroup analyses revealed higher prevalence among females, rural residents, individuals with lower education levels, and those living alone.

CONCLUSION

Depression prevalence among older adults in China decreased during the early pandemic response but showed an increasing trend over time, reflecting the complex mental health impact of prolonged public health measures. Effective interventions are needed to address the specific needs of vulnerable subgroups during and beyond public health crises.