Prevalence of depression among rural older adults in Asia: a meta-analysis of observational studies

Despite the prevalence of depression among rural older adults in Asia having been widely investigated, existing estimates remain highly inconsistent. This meta-analysis of observational studies aimed to quantify the pooled prevalence of depression and determine potential moderating factors among rural older adults in Asia.

A systematic literature search was performed in PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, and PsycINFO from inception to May 2026. Pooled prevalence estimates were calculated using a random-effects model, with both 95% confidence intervals and 95% prediction intervals reported for each estimate. Heterogeneity was assessed using the I² statistic, and subgroup analyses together with meta-regression were conducted to identify potential sources of heterogeneity.

A total of 68 studies comprising 58,577 rural older adults in Asia were included, yielding a pooled prevalence of depression of 34.6% (95% CI: 29.9-39.6%, 95% PI: 3.9-75.9%, I ² = 99.3%). The pooled prevalence was significantly associated with mean age, proportion of married participants, economic status, and geographic region (all p < 0.05).

Our findings indicate that depression is common among rural older adults in Asia. The pooled prevalence estimate exhibited substantial statistical heterogeneity and a wide prediction interval, only partly accounted for by covariates such as mean age, proportion of married participants, economic status, and geographic region. Therefore, caution is advised when interpreting this estimate in clinical practice. Furthermore, the substantial mental health burden in this population highlights the urgent need for routine screening and tailored interventions to reduce depression. Systematic review registration: CRD420261411159.