Trajectories of depressive symptoms across different age groups from adolescence to old age before and during the COVID-19 pandemic: A national household survey in China

Objective: The COVID-19 pandemic has been associated with depressive symptoms. However, little is known about trajectories across different age groups. This study aimed to examine trajectories of depressive symptoms before and during the COVID-19 pandemic across different age groups and identify factors associated with these trajectories. Methods: This population-based household survey included 19,545 participants from various age groups (10-18 years, n = 2260; 19-34 years, n = 4801; 35-49 years, n = 4892; 50-64 years, n = 5238; 65+ years, n = 2354) in two waves conducted in 2018 and 2020. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were used for data analysis. Results: An increase in depressive symptoms was observed during the COVID-19 pandemic compared to the preCOVID period. Four trajectories of depressive symptoms were identified: High-risk, increasing, decreasing, and low-risk. Female gender and lower income in older age groups, as well as lower levels of exercise in older age groups, poorer physical health in all ages, and lower well-being in all ages were identified as risk factors for experiencing depressive symptom trajectories compared with the low-risk trajectory. Limitations: Self-reported tools other than clinical diagnosis were employed. Conclusions: This population-based study highlights the importance of tailoring prevention and intervention strategies for different age groups, considering specific risk and protective factors. Such targeted approaches can effectively address the diverse trajectories of depressive symptoms observed during the COVID-19 pandemic.