Systematic Review and Meta-Analysis on the Prevalence of Depressive Symptoms in Older Adults Attending Primary Health Care in Brazil

Depressive symptoms represent an important mental health concern among older adults and may be particularly relevant in Primary Health Care (PHC), where chronic conditions, functional limitations, and social vulnerabilities associated with ageing are frequently managed. Objective: To estimate the pooled prevalence of depressive symptoms among older adults attending Primary Health Care in Brazil. Methods: A systematic review and meta-analysis of quantitative studies involving adults aged 60 years or older receiving care, registered, or followed in Brazilian PHC services was conducted. Twelve independent studies published between 2010 and 2024 were included. Prevalence estimates were pooled using a random-effects model with logit-transformed proportions and restricted maximum-likelihood estimation. Heterogeneity was assessed using Cochran's Q, I2, and τ2 statistics, and a 95% prediction interval was calculated. Results: The 12 studies included 4,366 older adults, of whom 1,145 presented depressive symptoms. Individual prevalence estimates ranged from 18.0% to 60.0%. The pooled prevalence was 30.1% (95% CI: 24.6%-36.3%), with substantial between-study heterogeneity (I2 = 93.1%; τ2 = 0.219; Q(11) = 159.14; p < .001). The 95% prediction interval ranged from 14.2% to 53.0%. Sensitivity analyses produced similar estimates, supporting the robustness of the principal finding. Conclusion: Depressive symptoms affect a substantial proportion of older adults represented in Brazilian PHC studies, although prevalence varies considerably across settings. These findings reinforce the importance of integrating mental health assessment into comprehensive older-person care and highlight the need for standardized, longitudinal, and geographically representative investigations within Brazilian Primary Health Care.