Co-occurrence of depressive and anxious symptoms and their influence on self-rated health: a national representative survey among Chinese older adults

Abstract

Objectives

The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH).

Method

This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables.

Results

The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH.

Conclusion

CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults.

Keywords:

• Depressive symptoms
• anxious symptoms
• self-rated health
• co-occurrence
• epidemiology

Acknowledgements

The authors thank the staff and the participants of the CLHLS study.

Ethical approval and consent to participate

The CLHLS was approved by the Biomedical Ethics Committee of Peking University (IRB00001052-13074). Each participant or his/her legal representative provided written informed consent.

Author’s contributions

XL and ZW conceptualized the study. SH analyzed the data and drafted the manuscript. JW, HW, XY, ZW, and XL reviewed and revised the manuscript. SH, JW, YZ, YQ, HW, XY, ZW, and XL contributed to interpretation of the data and discussion. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets supporting the conclusions of this article are available in https://opendata.pku.edu.cn/dataverse/CHADS.

Additional information

Funding

This work was supported by the National Natural Science Foundation (82003539, 82271584) and the Capital’s Funds for Health Improvement and Research (CFH2020-3-4114). The funding agency had no role in the design of the study; in collection, analysis or interpretation of the data; in writing or approving the manuscript; or in the decision to submit the manuscript for publication.