Skip to main content

Advertisement

SpringerLink
Log in

Poor mental health status and its associations with demographic characteristics and chronic diseases in Chinese elderly

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

Although poor mental health is associated with significant personal and societal burden, it is rarely reported in older Chinese populations. This study examined the mental health status of a large representative sample of Chinese elderly in relation to socio-demographic characteristics, lifestyle, and chronic diseases.

Methods

Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people aged between 60 and 79 years were selected and interviewed with standardized assessment tools. The 12-item General Health Questionnaire (GHQ-12) was used to measure general mental health with the total score of ≥4 as the threshold for poor mental health status.

Results

The adjusted percentage of poor mental health status in the whole sample was 23.8 %; 18.5 % in men and 28.9 % in women. Multivariate logistic regression analysis revealed that female gender, widowed/separated marital status, rural abode, low income, poor diet, lack of physical exercise, and multi-morbidity were independently associated with poor mental health. The percentage of poor mental health status was significantly higher in patients with anemia, diabetes, hyperlipidemia, cataract/glaucoma, ischemic heart disease, cerebrovascular diseases, nasopharyngitis, chronic gastroenteritis/peptic ulcer, liver diseases, cholecystitis/gallstone, arthritis, or chronic low back pain.

Conclusion

Given the high rate of poor mental health status among older Chinese population, policy makers and health professionals in China should address the mental health burden of its aging population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA (2013) Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual Life Res Intern J Qual Life Asp Treat Care Rehabil 22:791–799

    Article  Google Scholar 

  2. Boey KW, Chiu HFK (2005) Life strain and psychological distress of older women and older men in Hong Kong. Aging Mental Health 9:555–562

    Article  CAS  PubMed  Google Scholar 

  3. Bowling A (2007) Gender-specific and gender-sensitive associations with psychological health and morbidity in older age. Baseline findings from a British population survey of ageing. Aging Mental Health 11:301–309

    Article  PubMed  Google Scholar 

  4. Chiu HF, Yip PS, Chi I, Chan S, Tsoh J, Kwan CW, Li SF, Conwell Y, Caine E (2004) Elderly suicide in Hong Kong—a case-controlled psychological autopsy study. Acta Psychiatr Scand 109:299–305

    Article  CAS  PubMed  Google Scholar 

  5. Consultation WE (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363:157–163

    Article  Google Scholar 

  6. Cornah D (2006) Cheers? Understanding the relationship between alcohol and mental health. Mental Health Foundation, UK

    Google Scholar 

  7. do Nascimento KK, Pereira KS, Firmo JO, Lima-Costa MF, Diniz BS, Castro-Costa E (2015) Predictors of incidence of clinically significant depressive symptoms in the elderly: 10-year follow-up study of the Bambui cohort study of aging. Intern J Geriatr Psychiatry 30:1171–1176

    Article  Google Scholar 

  8. Edmans J, Bradshaw L, Gladman JR, Franklin M, Berdunov V, Elliott R, Conroy SP (2013) The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units. Age Ageing 42:747–753

    Article  PubMed  PubMed Central  Google Scholar 

  9. Feng Z, Liu C, Guan X, Mor V (2012) China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Aff 31:2764–2773

    Article  Google Scholar 

  10. Fone DL, Dunstan F (2006) Mental health, places and people: a multilevel analysis of economic inactivity and social deprivation. Health Place 12:332–344

    Article  PubMed  Google Scholar 

  11. Forsman AK, Nyqvist F, Wahlbeck K (2011) Cognitive components of social capital and mental health status among older adults: a population-based cross-sectional study. Scand J Public Health 39:757–765

    Article  PubMed  Google Scholar 

  12. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H (2012) A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 10:142–151

    Article  PubMed  PubMed Central  Google Scholar 

  13. Fu R, Noguchi H (2016) Does marriage make us healthier? Inter-country comparative evidence from China, Japan, and Korea. PLoS One 11:e0148990

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gale CR, Harris A, Deary IJ (2016) Reaction time and onset of psychological distress: the UK Health and Lifestyle Survey. J Epidemiol Commun Health 70:813–817. doi:10.1136/jech-2015-206479

    Article  Google Scholar 

  15. Gomez-Pinilla F (2008) Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci 9:568–578

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Gorstein J, Sullivan K, Parvanta I, Begin F (2007) Indicators and methods for cross-sectional surveys of vitamin and mineral status of populations. The Micronutrient Initiative (Ottawa) and the Centers for Disease Control and Prevention (Atlanta)

  17. Hassanzadeh J, Asadi-Lari M, Ghaem H, Kassani A, Niazi M, Menati R (2016) The Association of Poor Mental Health Status and Sociocultural Factors in Men: A Population-Based Study in Tehran, Iran. Am J Men Health. doi:10.1177/1557988316630720

  18. Jokela M, Batty GD, Kivimaki M (2013) Ageing and the prevalence and treatment of mental health problems. Psychol Med 43:2037–2045

    Article  CAS  PubMed  Google Scholar 

  19. Katon W, von Korff M, Lin E, Bush T, Ormel J (1992) Adequacy and duration of antidepressant treatment in primary care. Med Care 30:67–76

    Article  CAS  PubMed  Google Scholar 

  20. Keqing L, Ze C, Lijun C, Qinpu J, Guang S, Haoran W, Jing H, Wuwen Z, Jianguo X, Yanping Z, Ben Z, Jianxun J, Xueyi W, Jun T, Yufu Z, Haishan H, Jianping G, Enyi Z (2008) Epidemiological survey of mental disorders in the people aged 18 and older in Hebei Province. Asian J Psychiatry 1:51–55

    Article  Google Scholar 

  21. Lopresti AL, Hood SD, Drummond PD (2013) A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 148:12–27

    Article  PubMed  Google Scholar 

  22. Ma X, Xiang YT, Li SR, Xiang YQ, Guo HL, Hou YZ, Cai ZJ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Ungvari GS, Chiu HF (2008) Prevalence and sociodemographic correlates of depression in an elderly population living with family members in Beijing, China. Psychol Med 38:1723–1730

    Article  CAS  PubMed  Google Scholar 

  23. Mui AC (2010) Productive ageing in China: a human capital perspective. China J Soc Work 3:111–123

    Article  Google Scholar 

  24. Naimi TS, Stockwell T, Zhao J, Xuan Z, Dangardt F, Saitz R (2016) Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality. doi:10.1111/add.13451

  25. National Bureau of Statistics of China (2013) China statistical abstract. Beijing, China

  26. Paul C, Ayis S, Ebrahim S (2006) Psychological distress, loneliness and disability in old age. Psychol Health Med 11:221–232

    Article  PubMed  Google Scholar 

  27. Phillips MR, Zhang J, Shi Q, Song Z, Ding Z, Pang S, Li X, Zhang Y, Wang Z (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373:2041–2053

    Article  PubMed  Google Scholar 

  28. Qu B, Li X, Liu J, Mao J (2012) Analysis of the current situation regarding the aging rural population in China and proposed countermeasures. Popul Health Manag 15:181–185

    Article  PubMed  Google Scholar 

  29. Resnick B, Perry D, Applebaum G, Armstrong L, Cotterman M, Dillman S, Elliott S, McCarthy M, Narrett M, Parrish S, Parrish JH (2003) The impact of alcohol use in community-dwelling older adults. J Community Health Nurs 20:135–145

    Article  PubMed  Google Scholar 

  30. Schneiderman N, Ironson G, Siegel SD (2005) Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol 1:607–628

    Article  PubMed  PubMed Central  Google Scholar 

  31. Schoenborn CA, Adams PE (2010) Health behaviors of adults: United States, 2005–2007. Vital and health statistics. Series 10, Data from the National Health Survey:1–132

  32. Schuckit MA (2009) Alcohol-use disorders. Lancet 373:492–501

    Article  PubMed  Google Scholar 

  33. Su D, Wu XN, Zhang YX, Li HP, Wang WL, Zhang JP, Zhou LS (2012) Depression and social support between China’ rural and urban empty-nest elderly. Arch Gerontol Geriatr 55:564–569

    Article  PubMed  Google Scholar 

  34. Tian T, Chen Y, Zhu J, Liu P (2015) Effect of air pollution and rural-urban difference on mental health of the elderly in China. Iran J Public Health 44:1084–1094

    PubMed  PubMed Central  Google Scholar 

  35. Unutzer J, Patrick DL, Simon G, Grembowski D, Walker E, Rutter C, Katon W (1997) Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 277:1618–1623

    Article  CAS  PubMed  Google Scholar 

  36. Walsh R (2011) Lifestyle and mental health. Am Psychol 66:579–592

    Article  PubMed  Google Scholar 

  37. Wang S, Kou C, Liu Y, Li B, Tao Y, D’Arcy C, Shi J, Wu Y, Liu J, Zhu Y, Yu Y (2015) Rural-urban differences in the prevalence of chronic disease in northeast China. Asia Pac J Public Health Asia Pac Acad Consort Public Health 27:394–406

    Article  Google Scholar 

  38. Wang SB, D’Arcy C, Yu YQ, Li B, Liu YW, Tao YC, Wu YH, Zhang QQ, Xu ZQ, Fu YL, Kou CG (2015) Prevalence and patterns of multimorbidity in northeastern China: a cross-sectional study. Public health 129:1539–1546

    Article  CAS  PubMed  Google Scholar 

  39. Wong TS, Xiang YT, Tsoh J, Ungvari GS, Ko FW, Hui DS, Chiu HF (2014) Depressive disorders in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a controlled study. Aging Mental Health 18:588–592

    Article  PubMed  Google Scholar 

  40. Xiang Y-T, Yu X, Sartorius N, Ungvari GS, Chiu HFK (2012) Mental health in China: challenges and progress. Lancet 380:1715–1716

    Article  PubMed  Google Scholar 

  41. Xiang YT, Ma X, Lu JY, Cai ZJ, Li SR, Xiang YQ, Guo HL, Hou YZ, Li ZB, Li ZJ, Tao YF, Dang WM, Wu XM, Deng J, Lai KY, Ungvari GS (2009) Alcohol-related disorders in Beijing, China: prevalence, socio-demographic correlates, and unmet need for treatment. Alcohol Clin Exp Res 33:1111–1118

    Article  PubMed  Google Scholar 

  42. Yamamoto N, Abe Y, Arima K, Nishimura T, Akahoshi E, Oishi K, Aoyagi K (2014) Mental health problems and influencing factors in Japanese women 4 months after delivery. J Physiol Anthropol 33:32

    Article  PubMed  PubMed Central  Google Scholar 

  43. Yang TZ, Huang L, Wu ZY (2003) The application of Chinese health questionnaire for mental disorder screening in community settings in mainland China. Chin J Epidemio 24:769–773

    CAS  Google Scholar 

  44. Zhu H, Gu D (2010) The protective effect of marriage on health and survival: does it persist at oldest-old ages? J Popul Aging 3:161–182

    Article  Google Scholar 

Download references

Acknowledgments

This study was funded by the Scientific Research Foundation of the Health Bureau of Jilin Province, China (Grant Number: 2011Z116).

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China

    Shibin Wang, Bo Li, Changgui Kou, Yawen Liu, Yuchun Tao, Yanhua Wu, Yingli Fu, Yue Qi & Yaqin Yu

  2. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Avenida da Universidade, 3/F, Building E12, Taipa, Macau SAR, China

    Shibin Wang & Yu-Tao Xiang

  3. University of Notre Dame Australia/Marian Centre, Perth, Australia

    Gabor S. Ungvari

  4. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia

    Gabor S. Ungvari

  5. Department of Psychiatry, University of Melbourne, Melbourne, Australia

    Chee H. Ng

  6. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China

    Helen F. K. Chiu

Authors
  1. Shibin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bo Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabor S. Ungvari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chee H. Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Helen F. K. Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Changgui Kou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yawen Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuchun Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yanhua Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yingli Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yue Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yaqin Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Yu-Tao Xiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Bo Li or Yu-Tao Xiang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest related to this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, S., Li, B., Ungvari, G.S. et al. Poor mental health status and its associations with demographic characteristics and chronic diseases in Chinese elderly. Soc Psychiatry Psychiatr Epidemiol 51, 1449–1455 (2016). https://doi.org/10.1007/s00127-016-1271-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-016-1271-y

Keywords

Search

Navigation