Prevalence, role impairment, and mental health service utilization of depressive disorders among community-dwelling older adults in China

Background Depressive disorders pose a significant public health burden, particularly among older adults. However, their prevalence, associated factors, role impairment, and mental health service utilization patterns among community-dwelling older ay -30dults in China remain understudied. Methods The data for this study were obtained from the China Mental Health Survey (CMHS) among participants aged 60 years and older. The World Health Organization Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was administered to generate mental disorder diagnoses consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). We calculated weighted prevalence of depressive disorders and applied multivariable logistic regression to identify associated factors, with further analyses of role impairment and mental health service utilization. Results The final sample encompassed 7,454 older adults. The weighted lifetime and 12-month prevalence of depressive disorders among Chinese community-dwelling older adults were 7.9% (95% CI: 6.4%-9.5%) and 4.1% (95% CI: 3.2%-4.9%), respectively. Multivariable logistic regression analysis showed that older adults with three or more physical illnesses exhibited greater odds of past-year depressive disorders (OR = 11.4, 95% CI: 7.0-18.6). Elevated odds were also observed among those with comorbid anxiety and substance use disorders (OR = 8.4, 95% CI: 5.5-12.8; OR = 8.9, 95% CI: 3.9-20.0, respectively). Among respondents with 12-month depressive disorders, 67.9% had role impairment in household duties, 73.2% in work, 62.2% in relationships, and 60.7% in social life. Only 11.3% of those diagnosed with depressive disorders in the past 12 months utilized any form of mental health service. Conclusions Depressive disorders are prevalent among community-dwelling Chinese older adults and are associated with various factors. Patients commonly experienced multi-domain role impairment, whereas mental health service uptake was low, calling for strengthened screening, intervention and accessible care for older adults.