title: A community-based study of depression in older people in Hefei, China--the GMS-AGECAT prevalence, case validation and socio-economic correlates.
abstract: OBJECTIVE
  Previously published studies of prevalence of depression in older people in China showed much variation in the results, while the pooled prevalence is low. In this study we used a standardised method, the Geriatric Mental State (GMS) to investigate the prevalence of depression in older people in China, validate the GMS-AGECAT depression cases and examine the relationship between depression and socio-economic deprivation.
  
  
  METHODS
  1736 subjects aged > or =65 were recruited from Hefei city, China. They were interviewed at home by a survey team from Anhui Medical Universtiy using the GMS and other interviews. Their mental disorders were diagnosed by the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT). Chinese psychiatrists re-examined depression cases and their controls.
  
  
  RESULTS
  39 depressed cases were diagnosed by the GMS-AGECAT. Age-standardised prevalence was 2.2% (95% CI 1.5-2.9), which was about five-times lower than that of older people in Liverpool, UK. Agreement on depression diagnoses between the GMS-AGECAT and local Chinese psychiatrists was 83.6%, with a Kappa of 0.67 (p<0.001). Depression was significantly related to socio-economic deprivation.
  
  
  CONCLUSIONS
  This community-based study suggested a low prevalence of depression in older people in urban China. Approved training in the use of the GMS-AGECAT in mainland China should make it possible to carry out a large scale epidemiological study on depression in the Chinese elderly population to investigate its geographic variation and risk factors. The dose-response relation between socio-economic deprivation and depression indicates that strategies for tackling inequality in depression in elderly are urgently needed in China.
authors.affiliation: School of Health Administration, Anhui Medical University, Hefei, China. r_chen77@yahoo.co.uk
authors.forename: Ruoling
authors.initials: R
authors.lastname: Chen
authors.forename: Zhi
authors.initials: Z
authors.lastname: Hu
authors.forename: Xia
authors.initials: X
authors.lastname: Qin
authors.forename: Xiaochao
authors.initials: X
authors.lastname: Xu
authors.forename: John R M
authors.initials: JR
authors.lastname: Copeland
mesh_terms: D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011203:Poverty; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors