Persistent socio-demographic inequalities in depression among older adults in China during and after COVID-19: a systematic review and meta-analysis

Objective

To examine socio-demographic inequalities in depressive symptoms among older adults in China during and after the COVID-19 pandemic and assess whether these inequalities remained stable or changed over time. Methodology: This systematic review and meta-analysis followed PRISMA guidelines. Nine English and Chinese databases were searched from 1 January 2020 to 15 June 2026. Eligible studies were conducted among community-dwelling adults aged ≥60 years in mainland China, used probability sampling and standardized measures of depressive symptoms, and reported cross-sectional data. Study quality was assessed using the 11-item Agency for Healthcare Research and Quality checklist. Potential publication bias was assessed using Begg's and Egger's tests and trim-and-fill analysis. Year-stratified prevalence and pooled odds ratios (ORs) were estimated for disparities by gender, marital status, urban-rural residence, living arrangement and educational attainment.