SynthesisFrontiers in public health2026
Persistent socio-demographic inequalities in depression among older adults in China during and after COVID-19: a systematic review and meta-analysis.
Synthesis in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To examine socio-demographic inequalities in depressive symptoms among older adults in China during and after the COVID-19 pandemic and assess whether these inequalities remained stable or changed over time. Methodology: This systematic review and meta-analysis followed PRISMA guidelines. Nine English and Chinese databases were searched from 1 January 2020 to 15 June 2026. Eligible studies were conducted among community-dwelling adults aged ≥60 years in mainland China, used probability sampling and standardized measures of depressive symptoms, and reported cross-sectional data. Study quality was assessed using the 11-item Agency for Healthcare Research and Quality checklist. Potential publication bias was assessed using Begg's and Egger's tests and trim-and-fill analysis. Year-stratified prevalence and pooled odds ratios (ORs) were estimated for disparities by gender, marital status, urban-rural residence, living arrangement and educational attainment. Results: Seventy-nine studies involving 199,116 older adults from 21 provincial-level regions were included; 52 studies were rated as high quality and 27 as moderate quality, with none rated as low quality. Pooled prevalence fluctuated across investigation years, from 16.6% (95% CI 12.1-22.4) in 2022 to 22.9% (95% CI 18.3-28.3) in 2024-2025, with substantial between-study heterogeneity (overall I Conclusion: Depressive symptoms among older adults in China fluctuated across the pandemic and post-pandemic periods, while socio-demographic inequalities remained broadly stable. Major public health disruption appeared more likely to expose and prolong pre-existing inequalities than fundamentally reshape them in the short term. These findings provide a useful comparative reference for understanding mental health vulnerability in aging societies facing public health emergencies. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025642200; identifier: CRD42025642200.
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