Association Between Functional Disability and Depressive Symptoms Among Older Adults in Rural China: A Cross-Sectional Study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> The association between functional disability and depressive symptoms among elderly people in rural China is not clear. This study explored the relationship between functional disability and depressive symptoms, focusing on whether an interactive association between functional disability, demographic characteristics and depressive symptoms exists among older adults in rural Anhui, China.<jats:bold>Methods:</jats:bold> A cross-sectional survey study was conducted with multi-stage stratified random sampling. The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. The data were analyzed using SPSS statistics 25.0 program with chi-square test, Mann-Whitney U test, binary logistic regression analysis, and classification and regression tree model.<jats:bold>Results</jats:bold>: The prevalence of depressive symptoms in 3336 older people was 52.94%. After adjustment, subjects who had problems in participation (adjusted odds ratio [AOR]=3.499, 95% confidence interval [CI]:2.385-4.987), life activities (AOR=1.683, 95% CI: 1.370-2.066), getting along (AOR=1.616, 95% CI: 1.299-2.010), and mobility (AOR=1.842, 95% CI: 1.503-2.258) had an increased depressive symptoms risk. However, cognition (AOR=0.785, 95% CI: 0.647-0.953) negatively correlated with depressive symptoms. Additionally, the interactive association between functional disability dimensions, various variables and depressive symptoms were identified for the first time. Those who had problems in mobility, getting along and were unemployed, the possibility of having depressive symptoms was the highest.<jats:bold>Conclusions:</jats:bold> Special attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along, and mobility and no problems in cognition to maintain a good psychological state. Our findings may be greatly significant for developing more targeted and effective mental health prevention and intervention measures for older adults in rural areas.</jats:p>