# Prevalence and associated factors of depressive symptoms among older adult diabetic patients in China: a nationally representative cross-sectional study

## TL;DR

This study finds that nearly 40% of older adults with diabetes in China experience depressive symptoms, with risk factors including low education, being female, poor sleep, and having other health issues.

## Contribution

The study provides nationally representative evidence on depressive symptoms in older diabetic patients in China and identifies key sociodemographic and health-related risk factors.

## Key findings

- The prevalence of depressive symptoms among older diabetic patients in China is 38.6%.
- Female sex, lower education, shorter sleep duration, and comorbidities are significant risk factors for depressive symptoms.
- Personalized psychological interventions are recommended for high-risk groups to improve quality of life.

## Abstract

Diabetes and depressive symptoms exhibit a high comorbidity in the older adult population, and their combined effects significantly reduce patients’ quality of life. This study aims to investigate the prevalence of depressive symptoms among older adults with diabetes in China and identify key associated factors, providing evidence-based insights for the development of targeted intervention strategies.

This study utilizes data from the 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS), including older adults aged 60 years and above who have been diagnosed with diabetes (n = 3,609). Depressive symptoms were assessed using the simplified version of the CES-D scale, a validated tool for measuring depressive symptoms, with a score of ≥10 indicating depressive symptoms. Univariate chi-square tests and logistic regression analysis were used to examine the factors associated with depressive symptoms, with statistical significance set at p < 0.05.

The overall prevalence of depressive symptoms among older adult diabetic patients in the sample was 38.6%. Univariate chi-square analysis revealed significant differences in variables including age (χ2 = 4.048, p = 0.044), gender (χ2 = 96.725, p < 0.001), educational level (χ2 = 110.545, p < 0.001), and sleep duration (χ2 = 161.070, p < 0.001) between the groups with and without depressive symptoms. Logistic regression analysis identified lower educational level (OR = 1.26, 95% CI: 1.03–1.55, p = 0.026), female sex (OR = 1.51, 95% CI: 1.22–1.88, p < 0.001), and shorter sleep duration (OR = 1.76, 95% CI: 1.41–2.18, p < 0.001) as independent risk factors for depressive symptoms. Furthermore, patients with comorbidities had a significantly increased risk of depressive symptoms (OR = 1.35, 95% CI: 1.06–1.72, p = 0.015).

The high prevalence of depressive symptoms among older adult diabetic patients is significantly associated with sociodemographic, lifestyle, and health-related factors. Personalized psychological interventions should be prioritized for high-risk groups, including individuals with low education levels, women, those experiencing insufficient sleep, and those with multiple comorbidities, in order to enhance their quality of life and reduce social burdens.