Recognition and management of late-life depression in Chinese primary care: a narrative review on evidence-based strategies for community practice

Late-life depression is highly prevalent yet severely underdiagnosed among older adults in Chinese primary care settings. This narrative review synthesised evidence from 82 high-quality sources, with publication years spanning 1983 to 2024, identified through systematic searches of PubMed/MEDLINE, Web of Science, the Cochrane Library, CNKI, Wanfang, and VIP databases. The findings support culturally adapted strategies for community practitioners, including validated screening tools (e.g. the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) with an optimal cut-off of 6–8, and the Chinese version of the Geriatric Depression Scale-15 (GDS-15) with a cut-off of 5–7), a stepped-care treatment model integrating selective serotonin reuptake inhibitors (SSRIs; “start low, go slow”), problem-solving therapy, and Traditional Chinese Medicine (e.g. Tai Chi). Collaborative care models are also recommended to improve detection and management. Success hinges on addressing stigma, involving families, and integrating evidence-based Western and traditional approaches to reduce the treatment gap in China’s ageing population.