With the population aging, mental health of the middle-aged and elderly adults is of great concern, especially in middle-aged and elderly women. Compared with urban women, rural women are more likely to suffer from mental diseases due to their poorer health status, lower education level and backward living conditions, however, the accessibility of mental health services among them is low.

To understand the prevalence of depression among middle-aged and elderly women in rural China and analyze its influencing factors, in order to provide empirical evidence for improving the mental health of middle-aged and elderly women.

From May to July 2021, the follow-up data of the 2018 China Health and Retirement Longitudinal Study (CHARLS) was extracted, and rural women aged 45 years and above were selected as the study subjects (n=6 736) . The scores of the simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D) were used to determine the depression status of rural middle-aged and elderly women. Chi-square tests and multivariate Logistic regression model were used to analyze the influencing factors of the occurence of depressive symptoms among rural middle-aged and elderly women (including individual characteristics, health behaviors, social participation and utilization of medical services utilization) .

The CES-D score of 6 736 rural middle-aged and elderly women was (20.0±6.9) , 42.46% (2 860/6 736) of whom had depressive symptoms. The results of multivariate Logistic regression analysis showed that satisfication with health status〔OR (95%CI) =0.40 (0.36, 0.45) 〕, sleep duration ≥6 h〔OR (95%CI) =0.48 (0.43, 0.54) 〕, Internet use〔OR (95%CI) =0.63 (0.50, 0.80) 〕 and satisfication with life 〔OR (95%CI) =0.25 (0.21, 0.30) 〕 were correlated with lower risk of depression; hysical disability〔OR (95%CI) =1.41 (1.16, 1.71) 〕, suffering from chronic diseases〔OR (95%CI) =1.35 (1.21, 1.50) 〕, receiving outpatient services within 1 month〔OR (95%CI) =1.25 (1.09, 1.43) 〕 and hospitalization services within 1 year〔OR (95%CI) =1.31 (1.13, 1.52) 〕 were correlated with higher risk of depression.

Based on the results of this study, the depression status of middle-aged and elderly women in rural China is relatively severe and affected by individual characteristics, health behaviors, social participation, and the medical services utilization. It is recommended that governments and civil affairs departments at all levels pay close attention to the mental health of rural middle-aged and elderly women, especially through the intervention and prevention from multiple dimensions such as health promotion and education, medical service quality, and accessibility of information, in order to promote the construction of healthy villages and process of health aging in China.