Age-Specific Determinants of Depression Prevalence: Insights from Pre- and Post-COVID- 19 Pandemic Analysis

Background The COVID-19 pandemic has significantly impacted mental health, particularly increasing depression rates due to social isolation, economic stress, and lifestyle disruptions. However, studies examining its specific effects on depression on difference ages remain limited. Methods This study utilized data from the NHANES database, comparing pre-pandemic (2017–2020) and post-pandemic (2021–2023) cycles. Depression was assessed using the Patient Health Questionnaire (PHQ-9). Demographics, lifestyle behaviors, and medical conditions were examined as potential exposure variables. Logistic regression models were applied to determine the factors associated with depression in three groups: 20–44 years, 45–64 years, and 65–80 years. Results The analysis included 3,247 participants, with 871 in the depression group and 2,376 in the non-depression group. Alcohol abuse increased depression risk, while physical activity was protective across all age groups. In the 20–44 years group, COVID-19 experience (OR = 2.542, 95% CI: 1.783–3.623) and liver disease were significant risk factors. In the 65–80 years group, higher BMI (OR = 1.660, 95% CI: 1.139–2.421), thyroid disease (OR = 1.756, 95% CI: 1.001–3.079, p = 0.049), and longer weekend sleep (OR = 1.291, 95% CI: 1.020–1.634, p = 0.033) were significant. Female and heart/brain diseases elevated depression risk in middle-aged and older adults. Conclusion These findings emphasize the need for age-specific mental health interventions targeting pandemic stressors, chronic diseases, and gender disparities, informing future public health strategies.