Social Activities and Depressive Symptoms Among Elderly Based on Rural and Urban Differences in China: a National Cross-Sectional Study

Objective: Depression has become an important global public health problem. Despite the government's efforts, the outlook regarding the health issue of elderly depression in China is still not optimistic. This study explored the association between social activities and depressive symptoms among Chinese urban and rural elderly. Methods: Data were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study sample included 5101 Chinese adults aged >= 65 years. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Binary logistic regression analyses were used to explore the relationship between social activities and depressive symptoms. Results: The prevalence rate of depressive symptoms in rural elderly is 1.37 times higher than that in urban elderly. The proportion of elderly persons participating in a social activity less than once monthly, or never having participated in social activities is higher in rural areas than in urban areas. The results from the logistic regression model analysis show that among rural elderly, visiting others' homes or interacting with friends at least once a month or once a week is positively associated with depressive symptoms. Playing cards or mahjong at least once a week or almost daily is negatively associated with depressive symptoms. Participating in organized social activities once a month is negatively associated with depressive symptoms. None of these five activities significantly correlate with depressive symptoms among urban older adults. Conclusion: This study explored the differences in depressive symptoms among elderly populations in urban and rural China, as well as the impact of social activity participation on depressive symptoms. This study underscores the necessity of targeted social interventions in rural areas to enhance social participation among the elderly and reduce depressive symptoms.