Prevalence of depressive symptoms and associated factors among empty-nest elderly in China: a meta-analysis

The empty-nest elderly may be particularly vulnerable to mental health problems, including depressive symptoms. However, estimates of the prevalence of depressive symptoms and associated factors among the empty-nest elderly in China vary substantially across studies. This meta-analysis was conducted in accordance with the PRISMA guidelines. PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases were systematically searched. Pooled prevalence estimates and odds ratios for associated factors were calculated with their 95% confidence intervals. All analyses were performed using Stata 18.0. A total of 17 cross-sectional studies involving 23,782 participants were included. The pooled prevalence of depressive symptoms was 30% (95% CI 24%–37%), with extremely high heterogeneity across studies (I² = 99.2%). This result represents an average estimate across heterogeneous study settings rather than a precise national prevalence. Low income (OR = 2.71, 95% CI 1.81–4.06), chronic disease (OR = 2.15, 95% CI 1.54–3.01), lack of exercise (OR = 2.20, 95% CI 1.64–2.95), limited activities of daily living (OR = 1.71, 95% CI 1.14–2.56), and poor sleep quality (OR = 2.16, 95% CI 1.45–3.24) were associated with higher odds of depressive symptoms. These associations were derived from cross-sectional studies and should not be interpreted as causal. The high prevalence of depressive symptoms among empty-nest elderly in China highlights the need for targeted psychosocial and healthcare interventions for this population.