关键词: 抑郁, 农村人口, 老年人, 中国健康与养老全国追踪调查, 随机森林, Logistic模型, 影响因素分析

Abstract: Background　Along with the population aging and deepening understanding of healthy aging，the mental health status of a large group，aged people in China's rural areas，has received considerable attention. Objective　To explore the factors associated with depressive symptoms in China's rural elderly，providing evidence for promoting healthy aging in this group. Methods　This study was conducted in November 2020. Participants（3 068 China's rural elderly people aged 60 and over） were part of individuals who attended the 2018 CHARLS supported by Peking University. The short version of the Center for Epidemiologic Studies Depression Scale-Short Form（CES-D-SF） was used to assess the prevalence of depressive symptoms. The random forest algorithm was used to screen and sort the items associated with depression symptoms. Binary Logistic regression analysis was used to identify associated factors of depressive symptoms. Results　The top six of the 15 items associated with depression symptoms ranked in terms of importance were：self-reported health status，nap duration，life satisfaction，night sleep duration，education level，and marital satisfaction.The average score of CES-D-SF for the participants was（9.9±6.9） points.It was found that 1 679 cases（54.7%） had depressive symptoms，and 1 389（45.3%） did not. Binary Logistic regression analysis indicated that gender 〔female：OR=1.710，95%CI（1.422，2.057）〕，education level〔junior high school or above ：OR=0.663，95%CI（0.507，0.866）〕，nap duration〔6-8 h：OR=0.506，95%CI（0.425，0.601）；>8 h：OR=0.435，95%CI（0.324，0.580）〕，intergenerational emotional supports〔more：OR=1.297，95%CI（1.077，1.562）〕，life satisfaction 〔unsatisfied：OR=5.179，95%CI（3.814，7.133）〕，marital satisfaction 〔unsatisfied：OR=3.181，95%CI（2.264，4.526）；no spouse：OR=1.243，95%CI（1.004，1.538）〕，overall self-rated health 〔fair：OR=1.512，95%CI（ 1.199，1.915）；poor：OR=3.918，95%CI（3.056，5.043）〕，chronic diseases 〔have：OR=1.232，95%CI（1.041，1.457）〕，childhood health status 〔fair：OR=1.349，95%CI（1.107，1.644）〕 were associated with depressive symptoms（P<0.05）. Conclusion　The emotional status of the rural elderly was not optimistic，nearly half of them had depressive symptoms，which may be associated with gender，education level，nep duration，intergenerational emotional support，life satisfaction，marital satisfaction，overall self-rated health，chronic disease prevalence，and childhood health status. To promote the development of healthy aging in China，the prevention and control of depressive symptoms in high-risk individuals in this group shall be multifactorial with priority.

Key words: Depression, Rural population, Aged, China health and retirement longitudinal survey, Random forest, Logistic models, Root cause analysis