Depression Risk Among Chinese Middle-Aged and Older Adults Based on CHARLS 2020 Survey Data

Background: Depression has emerged as a major public health concern among middle-aged and older adults in China. While prior research has focused on demographic and socioeconomic factors, the impact of modifiable lifestyle behaviors on depression remains insufficiently understood. Objective: To examine the associations between daily lifestyle behaviors—including sleep duration, physical activity, and digital or social engagement—and depression risk and subjective health among Chinese older adults. Methods: We conducted a cross-sectional analysis using data from the 2020 China Health and Retirement Longitudinal Study (CHARLS). Depression was defined as a CES-D10 score ≥10. Key independent variables included sleep duration, physical activity, alcohol consumption, smoking status, and participation in internet use and social activities. Modified Poisson regression and logistic models were employed to assess associations with depression risk, self-rated health, and health satisfaction, adjusting for age, gender, marital status, education, income, region, and urban residence. Results: Among 15,935 eligible middle-aged and older adults, the prevalence of depression was 45.1%. Longer sleep duration, participation in leisure and community activities, and digital engagement were associated with lower depression risk. Conversely, older age, female gender, lower income, and rural residence were associated with higher risk. Similar associations were observed for self-rated health and health satisfaction. Conclusion: Sleep duration, physical activity, and digital or social engagement were independently associated with depression and subjective health among older adults in China. These findings support the value of behavioral health strategies targeted toward the aging population.