关键词: 抑郁, 老年人, 水平和趋势, 影响因素分析, 面板数据

Abstract: Background　Older adults are at high risk of depressive symptoms，which can cause a heavy disease burden. The prevalence of depressive symptoms in this population has been reported in many studies，but its temporal trend has been rarely studied by large-sample studies. Objective　To investigate the temporal trend of prevalence of depressive symptoms and associated factors among Chinese older adults. Methods　From September to October 2020，from participants（≥ 60 years old） of 2011（n=6 609），2013（n=7 158），2015（n=8 231） CHARLS with complete data，including prevalence of depressive symptoms，demographics （gender，age，education level，self-rated health），individual behaviors （smoking，alcohol consumption，sleep duration），social support （marital status），socioeconomic characteristics （hukou type，employment status），and other factors （ medical insurance，pension insurance）. Panel data matching was performed based on the above-mentioned cross-sectional data，and 11 055 cases with fully recorded follow-up data were obtained for three period，constituting a balanced short panel data set with n=3 685 and T=3. The prevalence and temporal trend of depressive symptoms were calculated by the cross-sectional data and follow-up data. A random-effects Logit model with a panel dichotomous choice model was used to explore the factors influencing depressive symptoms prevalence. Results　In 2011，2013，and 2015，the prevalence of depressive symptoms in older adults calculated based on cross-sectional data was 41.6% （2 747/6 609），32.6% （2 333/7 158），and 35.5% （2 919/8 231），respectively，showing no statistically significant trend of change （APC=-3.890，P=0.557）. The prevalence of depressive symptoms in older adults calculated based on the panel data was 38.4%
（1 414/3 685），30.2%（1 114/3 685），and 35.3% （1 301/3 685），respectively，demonstrating no statistically significant trend of change （APC=-2.080，P=0.776）. The results of the random effects Logit model showed that male 〔OR=0.463，95%CI（0.377，0.569）〕，having a spouse 〔OR=0.659，95%CI（0.549，0.792）〕，higher level of education 〔OR=0.756，95%CI（0.661，0.867）〕，having pension insurance 〔OR=0.862，95%CI（0.767，0.969）〕 were associated with decreased prevalence of depressive symptoms，while poor self-rated health 〔OR=2.564，95%CI（2.276，2.890）〕，smoking 〔OR=1.249，95%CI（1.032，1.513）〕，abnormal sleep duration 〔OR=2.069，95%CI（1.838，2.332）〕，and rural hukou 〔OR=2.047，95%CI（1.658，2.529）〕 were associated with increased prevalence of depressive symptoms. Conclusion　The prevalence of depressive symptoms in Chinese older adults was high in general. To reduce the prevalence to ensure healthy aging，more efforts should be made to deliver interventions for the prevention and control of depressive symptoms to women，individuals with poor self-rated health，smoking，abnormal sleep duration，no spouse，low education level，rural hukou，or no pension insurance.

Key words: Depression；Aged；Level &, trend；Root cause analysis；Panel data