Background. Two recent surveys of depression among Chinese
elderly people sampled different
populations, used different case ascertainment methods and resulted in
seven-fold difference in prevalence rates. The present study was conducted
compare prevalence rates obtained with two
commonly used methods in the same population, and to examine the risk factors
Methods. The target population included all residents aged
65 years and over in a rural Chinese
community. Participants were interviewed for demographic and medical
information, examined by
a neurologist and administered Chinese versions of the Geriatric Depression
(GDS-S), the Cognitive Abilities Screening Instrument (CASI) and an Activities
of Daily Living
(ADL) form. Individuals who screened positive on the GDS-S were also
interviewed by a
psychiatrist for diagnosis according to the DSM-III-R criteria.
Results. Among the 1313 participants, 26% screened positive
GDS-S and 13% were diagnosed
as having a depressive disorder, including 6·1% with major depression.
Individuals with depressive
disorders were more likely to have poor ADL scores, lower CASI scores,
chronic physical illnesses. They were also more likely to be female, older,
illiterate and without a spouse, but adding
these variables did not increase the overall association with the GDS-S
Conclusions. Depression was quite common in this Chinese rural
geriatric population. The prevalence
rate was twice as high when judged by depression symptomatology rather
than clinical diagnosis.
The critical risk factors were functional impairments, poor cognitive
abilities and the presence of chronic physical illnesses.