What are the socioeconomic risk factors of depression among the elderly in China: a systematic review

Numerous studies have explored the socioeconomic risk factors of depression in late life, including within China, however, there has been no systematic review and synthesis of these findings. Our systematic review aims to identify, evaluate, and synthesize current evidence on potential socioeconomic risk factors associated with depression among the elderly in China. Four electronic academic databases (MEDLINE [via OVID], Social Sciences Citation Index (SSCI) [via Web of Science], APA PsycArticles [via EBSCOhost], and Wanfang [a Chinese database]) were searched from 2005 to March 2022 for national studies reporting evidence on potential associations between socioeconomic risk factors and depression among the elderly in China. Elder is defined as a person who is aged 60 and over. Forward and backward citation searches were also conducted. Data was extracted using a standardized form. Study methodological quality was assessed using the Liverpool University Quality Assessment Tools (LQAT). A narrative synthesis was performed. Thirty studies that met the review inclusion criteria were included. Across the studies, the evidence indicates that higher educational status, better financial status, better housing conditions, active social engagement, more social support and better neighborhood conditions reduced the risk of depression among the elderly in China. Evidence on associations between working status was equivocal, two studies found evidence suggesting that working after 60 increased the likelihood of depression, while another study suggested working after 60 decreased the likelihood of depression. The findings highlight the importance of considering socioeconomic factors in the prevention and treatment of depression among the elderly in China. To support elderly mental health, policies should focus on expanding educational opportunities, strengthening financial security, improving housing conditions, and supporting flexible employment options for the elderly. Additionally, enhancing social engagement, reinforcing social support networks, and developing community-based initiatives can help create a more inclusive and supportive environment for healthy aging. Further research is needed on the relationships between working status and depression among the elderly in China. The protocol was registered on PROSPERO: CRD42023483862.