Analysis of depression burden and trends in China's elderly population based on GBD database

Xie Nanzhen; Zeng Ying; Qin Yan; Li Fei; Chen Jiangmin; Yang Xi; Deng Xia

doi:10.11986/j.issn.1673-873X.2025.03.03

Abstract：Objective To analyze the current status and trends of depression burden in China's elderly population,providing evidence for psychological disease prevention in older adults.Methods Using depression incidence data from the Global Bur-den of Disease Study 2021(GBD 2021)database for China's elderly population,we employed Joinpoint regression analysis,estimated annual percentage change(EAPC),and age-period-cohort(APC)modeling via Joinpoint software and R language to characterize depression incidence and predict future trends.Results In 2021,the depression incidence rate among China's elderly was 5.35%,with higher rates in women than men.From 1990 to 2021,depression incidence showed an increasing trend with advancing age.Major depression incidence was significantly higher than mood disorders;while the 55-84 age group exhibited two incidence peaks during this period,the 85 or above age group demonstrated an initial slow increase followed by a gradual de-cline.EAPC analysis revealed an inverted U-shaped age pattern in depression incidence growth,peaking at 75-79 years.Major de-pression growth rates exceeded mood disorders,and female growth rates surpassed males.Temporal trends were segmented into five phases,with the fastest annual incidence increase occurring during 1990-1994 and the most significant decline during 1994-2000.The APC model confirmed significant age,period,and cohort effects:incidence progressively increased with age,and later birth co-horts showed higher depression risk at the same age.Bayesian APC(BAPC)modeling projected declining incidence rates from 2020 to 2030,however,absolute case numbers will continue rising due to China's accelerating population aging.Conclusion Depression risk remains a critical concern for China's elderly amid rapid aging and socioeconomic development.Targeted psychological prevention strategies in this population should be implemented through multifaceted approaches to reduce disease burden.