Relationship Between Depression and Social Support Among Elderly in China: A Systematic Review

Background/Purpose: Nationwide study reported that 39.86% of the Chinese elderly had depression. Studies in western world found that social support is a major contributor to depression. China is undergoing significantly societal and economic transitions that affect the quantity and quality of the Chinese older adults’ social support. The urbanization, “one child policy”, migration trends, and modernization result in the family fragmentation and the increase number of “empty-nested” families.

The aim of this review is to identify the prevalence of depression and its related factors among Chinese elderly population, and find out the relationship between social support and depression among Chinese older adults by using systematic review methods. The ultimate aim is to find the way to prevent late life depression and influence the relevant policies.

Methods: Databases: English electronic literature searches are conducted in using PsycINFO, SocINDEX, MEDLINE, Social Service Abstract, Social Work Abstracts, Sociological Abstracts, CINAHL, EMBASE, and Chinese electronic literature searches are conducted in using China Academic Journals Full-Text Database (CJFD), and VIP Database for Chinese Technical Periodics. To maximize the amount of the relevant literature, the review included all studies published by April 2016.

Keywords: The keywords used were “social support” OR “family support” OR “friend support” OR “friendship” OR “social capital” OR “Social network” OR “social relationship” OR “social contact” OR “instrumental support” OR “emotional support” OR “financial support” OR “social service” OR “social welfare” OR “social exclusion” OR “social closure” AND “depression” OR “depressive disorder*” OR “depressive symptom” OR “sadness” OR “dysthymic” OR “suicidal ideation” OR “mental health” OR “psychological well-being” AND “China” OR “Chinese” AND “age group 65+” OR “Aged” OR “Elderly” OR “Older” OR “Senior”

Inclusion and Exclusion Criteria: 1) quantitative Design; 2) region: mainland China; 3) peer review journal article; 4) acceptable definition of depression; 5) relationship between social support and depression.

Results: We find that 1) The methodological quality of the studies are medium to high, but less than half of the studies reported reliability measure of social support, validity of depression or social support;2) Most of the studies only focus on the east China; 3) the prevalence of depression varied across the studies due to different measurements and samples; 4) SES, health, gender, age, marital status, living arrangements and social support were significant factors related to depression; 5) The majority of the studies concentrated on the family support and the friend support, and found that they could relieve the geriatric depression; 6) very few scholars were interested in the effect of neighbors and formal social support.

Conclusions and Implications: In terms of the research, our findings suggest that 1) further well-designed studies addressing the reliability and validity of measures are needed; 2) to understand the whole older population in China, nation-wide studies are needed; 3) further studies are needed to explore sources of social support beyond family members.

Additionally, to prevent late life depression, Chinese policy makers should provide more support to their family to ease burden and encourage the family member to provide more support to the older adults.