Influencing factors of depression and anxiety among empty nesters    in China:a systematic review and meta-analysis

  • LIU Lu ,
  • JIANG Yunlan ,
  • XIE Hongmei ,
  • LU Yutong ,
  • CHEN Zengli ,
  • PENG Hanmei
Expand
  • 1. School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 610072, China;
    2. The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine

Received date: 2023-03-27

  Online published: 2024-11-19

Abstract

Objective: To systematically evaluate the influencing factors of depression and anxiety among empty nesters in China. Methods: The Chinese and English databases were searched from the inception to July 2022. The literature screening,quality assessment,and information extraction were performed by 2 researchers independently. RevMan 5.4 and Stata 15.0 were used for Meta-analysis. Results: A total of 22 studies with 34 911 participants were included. Among them,the related factors of depression were reported in 19 studies,and the related factors of anxiety in empty nesters were reported in 7 studies. The Meta-analysis suggested that the risk factors for depression among empty nesters were living without spouse [OR=1.39(1.21,1.59)],low frequency of children’s visits [OR=1.49(1.34,1.67)],living in rural areas[OR=1.40(1.22,1.62)],religious belief [OR=2.66(1.68,4.22)],poor self-rated health status [OR=2.16(1.80,2.58)],comorbid chronic diseases [OR=1.39(1.14,1.69)],physical pain [OR=2.09(1.62,2.70)],poor self-care ability in life [OR=2.01(1.22,3.32)],multiple somatic disorders [OR=1.98(1.71,2.29)],and poor economic status [OR=2.43(1.96,3.02)]. The protective factors for depression among empty-nesters were high education level [OR=0.80(0.71,0.90)],living no alone [OR=0.61(0.39,0.95)],physical exercise [OR=0.42(0.29,0.61)],drinking [OR=0.52(0.34,0.97)],and high social support [OR=0.96(0.94,0.98)]. Gender and age were not associated with depression among empty nesters(P>0.05). In addition,the risk factors for anxiety among empty nesters were poor economic status [OR=1.80(1.49,2.19)],living without spouse [OR=1.88(1.35,2.64)],religious belief [OR=2.39(1.74,3.27)],and multiple somatic disorders [OR=2.81(2.05,3.85)]. No significant associations were found among chronic diseases and anxiety in empty nesters(P>0.05). Conclusion: Numerous factors that contribute to depression and anxiety among empty nesters in China. Therefore,preventive measures should be timely taken to lower incidence of depression and anxiety in empty nesters of China.

Cite this article

LIU Lu , JIANG Yunlan , XIE Hongmei , LU Yutong , CHEN Zengli , PENG Hanmei . Influencing factors of depression and anxiety among empty nesters    in China:a systematic review and meta-analysis[J]. Journal of Baotou Medical College, 2024 , 40(10) : 60 -67 . DOI: 10.16833/j.cnki.jbmc.2024.10.013

References

[1] Zhang HH, Jiang YY, Rao WW, et al. Prevalence of depression among empty-nest elderly in China:a meta-analysis of observational studies[J]. Front Psychiatry, 2020, 11: 608.
[2] 国家统计局. 中国统计摘要: 2021[M]. 北京: 中国统计出版社, 2021.
[3] Chang Y, Guo XF, Guo L, et al. Comprehensive comparison between empty nest and non-empty nest elderly: a cross-sectional study among rural populations in Northeast China[J]. Int J Environ Res Public Health, 2016, 13(9): 857.
[4] Gao YL, Wei YB, Shen YD, et al. China's empty nest elderly need better care[J]. J Am Geriatr Soc, 2014, 62(9): 1821-1822.
[5] Wang L, Shentu QF, Xu BH, et al. The prevalence of anxiety on the empty-nest elders in China[J]. J Health Psychol, 2020, 25(2): 152-160.
[6] Zainal NZ, Kalita P, Herr KJ. Cognitive dysfunction in Malaysian patients with major depressive disorder: a subgroup analysis of a multicountry, cross-sectional study[J]. Asia Pac Psychiatry, 2019, 11(1): e12346.
[7] Suh GH, Gega L. Suicide attempts among the elderly in East Asia[J]. Int Psychogeriatr, 2017, 29(5): 707-708.
[8] 闫语, 尹文强, 张玉杰, 等. 城乡空巢老人抑郁症状及影响因素差异研究[J]. 现代预防医学, 2022, 49(3): 557-561.
[9] Zhou JJ, Xiao LL, Zhou YC, et al. The depression status of empty nesters in eastern rural China[J]. Soc Behav Personality, 2019, 47(2): e7555.
[10] 齐芳. 住院空巢老人焦虑抑郁和主观幸福感现状及影响因素研究[J]. 护理管理杂志, 2016, (6): 385-387.
[11] 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
[12] 谭建刚, 杨涛, 曹承建, 等. 杭州市空巢老人抑郁现状及其影响因素研究[J]. 中国卫生统计, 2021, 38(4): 593-596.
[13] 朱小红, 李建宏, 张帆. 空巢老人焦虑现状调查及社区干预举措研究[J]. 职业与健康, 2020, 36(15): 2108-2111.
[14] 王瑶瑶, 陈宗涛, 李婷. 空巢老人焦虑和抑郁因素分析及心理干预效果研究[J]. 老年医学与保健, 2020, 26(6): 1060-1063, 1076.
[15] Huang GG, Duan YY, Guo F, et al. Prevalence and related influencing factors of depression symptoms among empty-nest older adults in China[J]. Arch Gerontol Geriatr, 2020, 91: 104183.
[16] 张持晨, 李咪咪, 赵慧宁, 等. 空巢老人焦虑状况及影响因素的logistic回归与决策树分析[J]. 中国心理卫生杂志, 2019, 33(8): 598-600.
[17] 丁颖, 闫成锐, 马晓丽, 等. 社区空巢老人焦虑抑郁现状及影响因素分析[J]. 安徽医学, 2019, 40(8): 947-950.
[18] Yao YC, Ding GQ, Wang LL, et al. Risk factors for depression in empty nesters: a cross-sectional study in a coastal city of Zhejiang Province in China[J]. Int J Environ Res Public Health, 2019, 16(21): 4106.
[19] Zhang CC, Xue YQ, Zhao HN, et al. Prevalence and related influencing factors of depressive symptoms among empty-nest elderly in Shanxi, China[J]. J Affect Disord, 2019, 245: 750-756.
[20] 王侠, 化前珍, 段思柳, 等. 陕西省空巢老人抑郁现状及影响因素分析[J]. 中华现代护理杂志, 2018, 24(14): 1644-1648.
[21] 苏桦, 张丹霞, 董时广, 等. 2014年深圳市福田区空巢老人抑郁孤独情绪状况及影响因素分析[J]. 实用预防医学, 2016, 23(8): 942-946.
[22] 宫凤凤. 安徽省某农村地区空巢老年人抑郁检出率及其影响因素的横断面研究[D]. 安徽医科大学, 2016.
[23] 李翠翠, 江珊, 杨婷婷, 等. 山东省城乡空巢独居老人抑郁状况及影响因素[J]. 中国公共卫生, 2015, 31(12): 1587-1589.
[24] Zhai YJ, Yi HM, Shen W, et al. Association of empty nest with depressive symptom in a Chinese elderly population: a cross-sectional study[J]. J Affect Disord, 2015, 187: 218-223.
[25] 李丹丹, 臧娜, 何培丽, 等. 安徽省某镇空巢老人抑郁因素分析[J]. 皖南医学院学报, 2013, 32(1): 79-81.
[26] 陈正英, 楚婷. 民族地区空巢老人抑郁状况调查及影响因素[J]. 中国老年学杂志, 2012, 32(1): 130-131.
[27] 马颖, 傅华, 王家骥, 等. 中国4省市社区空巢和非空巢老人抑郁症状及相关影响因素研究[J]. 中华流行病学杂志, 2012, 33(5): 478-482.
[28] 刘芳, 高柏成, 朱小松, 等. 武汉市某大学医学院空巢老人抑郁症状的发生情况及其影响因素[J]. 医学与社会, 2011, 24(12): 75-77.
[29] 潘毅慧. 芷江西社区空巢老人抑郁焦虑状况调查及干预研究[D]. 复旦大学, 2011.
[30] 谢姣, 高艳斌. 城市空巢老人焦虑抑郁发生率与社会支持的相关性[J]. 中国老年学杂志, 2009, 29(21): 2785-2786.
[31] 林婉丽, 郑萍, 张淑萍, 等. 住院空巢老人焦虑和抑郁情况及其影响因素的调查分析[J]. 中国护理管理, 2008, 8(6): 30-32.
[32] 贾守梅, 时玉洁, 周浩, 等. 上海市社区空巢老人焦虑状况及其影响因素研究[J]. 护理研究: 中旬版, 2007, 21(12): 3224-3226.
[33] 刘丽婷, 胡海霞, 高玉霞. 国内外原发性老年抑郁相关因素的研究进展[J]. 中国老年学杂志, 2014, 34(2): 547-549.
[34] 安涛. 体育锻炼对老年人心理健康的影响[J]. 中国老年学杂志, 2019, 39(3): 588-591.
[35] 邢荔函, 杜立琛, 牛越, 等. 老年抑郁症患病危险因素研究[J]. 中国卫生统计, 2019, 36(6): 866-869.
[36] Clark AE, D'ambrosio C, Ghislandi S. Adaptation to poverty in long-run panel data[J]. Rev Econ Stat, 2016, 98(3): 591-600.
[37] Shao L, Yu GL, Zhang DH. The mechanisms underlying the negative effect of depression on life satisfaction among the elderly: the roles of ostracism and economic income[J]. Int Psychogeriatr, 2021: 1-10.
[38] Menec VH, Newall NE, Mackenzie CS, et al. Examining individual and geographic factors associated with social isolation and loneliness using Canadian longitudinal study on aging (CLSA) data[J]. PLoS One, 2019, 14(2): e211143.
[39] Wang ZQ, Shu DF, Dong BR, et al. Anxiety disorders and its risk factors among the Sichuan empty-nest older adults:a cross-sectional study[J]. Arch Gerontol Geriatr, 2013, 56(2): 298-302.
[40] Huang LJ, Du WT, Liu YC, et al. Loneliness, stress, and depressive symptoms among the Chinese rural empty nest elderly: a moderated mediation analysis[J]. Issues Ment Health Nurs, 2019, 40(1): 73-78.
[41] Xie LQ, Zhang JP, Peng F, et al. Prevalence and related influencing factors of depressive symptoms for empty-nest elderly living in the rural area of YongZhou, China[J]. Arch Gerontol Geriatr, 2010, 50(1): 24-29.
[42] Chen ZC, Wu H, Wang XD, et al. Association between marital status and cognitive impairment based on a cross-sectional study in China[J]. Int J Geriatr Psychiatry, 2022, 37(1): 1-9.
[43] Yang YQ, Wen M. Filial piety and parental depressive symptoms:all children matter-evidence from rural northern China[J]. J Cross Cult Gerontol, 2021, 36(2): 155-167.
[44] Luo YL, Wu XL, Liao L, et al. Children's filial piety changes life satisfaction of the left-behind elderly in rural areas in China[J]. Int J Environ Res Public Health, 2022, 19(8): 4658.
[45] 黄伟, 乌日乐, 关鹏, 等. 中国空巢老人抑郁情况及其影响因素分析[J]. 中国公共卫生, 2016, 32(9): 1137-1140.
[46] Zhai SG, Zhuang Q, Wang ZX. Study on the relationship between social support and mental health of the elderly in China: a case study of Xi'an city, Shaanxi province[J].J Ment Health, 2019,28(2):119-124.
[47] Zhang CC, Chang YQ, Yun QL, et al. The impact of chronic diseases on depressive symptoms among the older adults: the role of sleep quality and empty nest status[J]. J Affect Disord, 2022, 302: 94-100.
[48] 李世平, 耿艳, 李锐曦, 等. 门诊空巢老年肿瘤患者焦虑抑郁情绪和主观幸福感调查及影响因素分析[J]. 肿瘤预防与治疗, 2021, 34(8): 752-756.
[49] Liu RT, Alloy LB. Stress generation in depression: a systematic review of the empirical literature and recommendations for future study[J]. Clin Psychol Rev, 2010, 30(5): 582-593.
[50] 阎红, 刘书文. 慢性病老年人心理健康现状及影响因素[J]. 中国老年学杂志, 2019, 39(21): 5366-5369.
[51] Liu HX, Fan XJ, Luo HY, et al. Comparison of depressive symptoms and its influencing factors among the elderly in urban and rural areas: evidence from the China health and retirement longitudinal study (CHARLS)[J]. Int J Environ Res Public Health, 2021, 18(8): 3886.
[52] Yang Z, Chen R, Hu X, et al. Factors that related to the depressive symptoms among elderly in urban and rural areas of China[J]. Zhonghua Liu Xing Bing Xue Za Zhi, 2017, 38(8): 1088-1093.
[53] Gong FF, Zhao DD, Zhao YY, et al. The factors associated with geriatric depression in rural China: stratified by household structure[J]. Psychol Health Med, 2018, 23(5): 593-603.
[54] Xiang XL, An R, Heinemann A. Depression and unmet needs for assistance with daily activities among community-dwelling older adults[J]. Gerontologist, 2018, 58(3): 428-437.
Outlines

/