AIMS AND OBJECTIVES: To estimate the prevalence of depressive symptoms in older people with hypertension in rural areas of China and to clarify the predictors influencing depressive symptoms in these patients.
BACKGROUND: Although many studies have described the prevalence of depressive symptoms in older people, these studies mainly focused on those in urban areas. Few studies explicitly clarify the depressive symptoms of older patients with hypertension in rural China.
DESIGN: A cross-sectional design was adopted for the study.
METHODS: A convenience sampling method was used to recruit the participants. The data were collected by questionnaire survey from the medical outpatient department of five rural township hospitals in Jinzhong City of Shanxi Province, northern China. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale-D, social support by the Social Support Rating Scale and activities of daily living by the Barthel Index.
RESULTS: Nine hundred forty-two rural older people with hypertension participated in the study. Of those, 560 patients (59.4%) had no depressive symptoms and 382 (40.6%) had depressive symptoms. The total mean scores of Center for Epidemiologic Studies Depression Scale-D for the normal group were 8.45 ± 6.47, and 14.18 ± 5.91 for the group with depressive symptoms; the statistical difference was observed by comparing the mean scores of Center for Epidemiologic Studies Depression Scale-D between the two groups (t = 2.18, p = .027). The binary logistic regression showed that the presence of depressive symptoms for older rural participants with hypertension was associated with the following factors: female (odds ratio [OR] = 1.19, 95% CI 1.10-1.37), unmarried status (OR = 1.36, 95% CI 1.19-1.65), low household income (OR = 0.80, 95% CI 0.74-0.93), living alone (OR = 1.76, 95% CI 1.45-1.90), the presence of hypertension complications and comorbid chronic diseases (OR = 0.63, 95% CI 0.42-0.74; OR = 0.55, 95% CI 0.41-0.69), dependent activities of daily living status (OR = 1.47, 95% CI 1.36-1.64) and low social support (OR = 1.66, 95% CI 1.57-1.89).
CONCLUSIONS: Depressive symptoms are common among older people with hypertension in rural China. The older patients with hypertension who are liable to have depressive symptoms warrant close attention from medical institutions and governments.
RELEVANCE TO CLINICAL PRACTICE: The study explores the potential factors related to depressive symptoms, understanding of which can contribute to the development of effective measures to ameliorate depressive symptoms and improve the healthcare outcomes for rural older people with hypertension.
