Postoperative Anxiety and Depression Among Chinese Elderly Patients

Prevalence and Risk Factors for Postoperative Anxiety and Depression Symptoms in Non-cardiac Surgery Among Chinese Elderly Patients

The goal of this observational study is to learn about the prevalence of postoperative anxiety and depression symptoms and identify the related risk factors in elderly patients aged 65 and older who undergo non-cardiac surgery in China.

The main questions it aims to answer are:

What is the prevalence rate of postoperative anxiety symptoms in elderly Chinese patients after non-cardiac surgery?

What is the prevalence rate of postoperative depression symptoms in elderly Chinese patients after non-cardiac surgery?

What are the risk and protective factors linked to postoperative anxiety and depression symptoms in this patient population?

Participants will undergo routine non-cardiac surgery as part of their standard medical care, and researchers will collect relevant clinical data and assess their anxiety and depression symptoms using standardized screening scales after surgery.

Study Overview

• Status: Completed
• Conditions: Depression; Anxiety

Detailed Description

This is a multicenter, retrospective observational study conducted across 19 medical centers in China, enrolling a total of 8590 elderly patients aged 65 years and above who received non-cardiac surgery between April 1, 2020, and April 30, 2022. The study was designed to fill the gap of lacking comprehensive epidemiological data on postoperative mental health disorders in this specific patient group in China, focusing on postoperative anxiety and depression symptoms that are tied to various adverse medical and social outcomes.

• Study Type: Observational
• Enrollment (Actual): 7568

Contacts and Locations

Study Locations

• China
  • Beijing Municipality
    • Beijing, Beijing Municipality, China, 100853
      • First Medical center of Chinese PLA General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Elderly patients (aged ≥ 65 years) who completed the anxiety and depression assessment after the elective noncardiac, non-neurosurgical surgery were included in this study.

Description

Inclusion Criteria:

1. elderly patients (age ≥ 65 years)
2. undergoing elective surgery with a planned overnight hospital stay following surgery
3. non-cardiac surgery, non-neurosurgical surgery
4. patients who complete the scale assessment

Exclusion Criteria:

1. patients fully refused to participate in the study
2. patients with severe dementia, language disorder, severe hearing or visual impairment, coma, and end-stage status
3. patients whose surgeries were canceled
4. history of previous severe mental illness or long-term use of psychotropic medications
5. patients admitted to ICU immediately after surgery
6. patients who died within 7 days after surgery

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anxiety	The GAD-7 is a seven-item questionnaire for screening on the presence of generalized anxiety disorder and assessing its severity. Items were scored on a four-point scale with total scores ranging from zero to twenty-one. Scores were defined as: ≥5 mild, ≥10 moderate, and ≥15 severe anxiety. The recommended screening cutoff was ≥10, corresponding with at least a moderate level of anxiety. Higher scores mean more anxiety.	within 7 days after surgery
Depression	Primary outcomes were depression Patient Health Questionnaire 9 (PHQ-9).The PHQ-9 is a nine-item questionnaire for screening on the presence of depressive symptoms and monitoring depression severity. Items were scored on a four-point scale with total scores ranging from zero to twenty-seven. Scores were defined as: ≥5 mild, ≥10 moderate, and ≥15 severe level of depression. The recommended screening cutoff was ≥10, corresponding with at least a moderate level of depression. The higher the score, the worse the situation. The total score ranges from 0 to 27, and higher scores indicate more depressive symptoms.	within 7 days after surgery

Collaborators and Investigators

• Sponsor: Chinese PLA General Hospital
• Collaborators: Peking University First Hospital; Xiangya Hospital of Central South University; Peking University People's Hospital; Sun Yat-sen University; Fudan University; Beijing Tiantan Hospital; Shanghai Zhongshan Hospital; The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School; Beijing Anzhen Hospital; China-Japan Friendship Hospital; Central South University; Zhejiang University; The Affiliated Hospital Of Guizhou Medical University; Zhejiang Provincial People's Hospital; First Affiliated Hospital of Xinjiang Medical University; Taihe Hospital; First Affiliated Hospital of Guangxi Medical University; Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2020
• Primary Completion (Actual): April 30, 2022
• Study Completion (Actual): May 30, 2022

Study Registration Dates

• First Submitted: April 9, 2026
• First Submitted That Met QC Criteria: April 9, 2026
• First Posted (Actual): April 15, 2026

Study Record Updates

• Last Update Posted (Actual): April 30, 2026
• Last Update Submitted That Met QC Criteria: April 25, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Behavior; Anxiety Disorders; Depression
• Other Study ID Numbers: PLAGH-Anxiety-Depression

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No