Gender differences and determinants of late-life depression in China: A cross-sectional study based on CHARLS

Background: Literature related to within-gender differences in depression among older individuals in China is sparse, and often limited to specific provinces. Methods: We analyzed data on 8104 participants from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS). Using logistic regressions, we identified the correlates of depressive symptoms among older individuals, both in the aggregate and along gender lines. Additionally, we examined the interaction between other covariates and gender. Results: The prevalence of late-life depression symptoms among females was 45.79%, which was higher than among males (31.13%, P < 0.01). Living in a rural area, earned income, education level, tobacco use and number of chronic diseases were correlated with depression in both genders (P < 0.05), with no interaction (Pint > 0.050). Social activities were correlated with depression in males but not in females (Pint = 0.373), inverse in their 70s (Pint = 0.020) group. The correlation between daily sleep duration and depression is stronger in females than in males (Pint <= 0.020). Female who drunk <1 per month decreased their prevalence of depression, but it increased in males (Pint = 0.001). Taking part in LTPA and being a religious believer were correlated with depression in females (P < 0.05), but not in males (P(LTPA)int = 0.009; P(religious believers)int = 0.033). Limitations: Since only analyzed one wave of data, we could not conclude that there was causation. Conclusions: Geriatric depression is a serious mental health issue in China. There is, an urgent need for prevention and intervention activities for older individuals, and these needs diverge along gender lines.