Burden of anxiety, depression and stress among older adults living in South-East Asia: Protocol for a systematic review and meta-analysis.

INTRODUCTION: Depression, anxiety and stress are major contributors to the global burden of diseases. The ageing population faces an escalating burden of these conditions, and half of the cases are largely undiagnosed. Yet a paucity of epidemiological data limits understanding the full scope of the disease burden among older adults. This protocol outlines a systematic review to estimate the prevalence and incidence of anxiety, depression and stress among older people (60 years and above) and to identify contributing factors across South-East Asian countries. METHOD AND ANALYSIS: A study protocol for a systematic review and meta-analysis has been registered in PROSPERO. The research team will systematically search, appraise and synthesise observational studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive searches will be conducted from inception to May 2025 across PubMed (NCBI), MEDLINE (Ovid), Web of Science, Cochrane Library, Scopus (Elsevier) and PsycINFO (APA), supplemented by grey literature from government reports, the WHO Library and Google Scholar. Two investigators will independently screen titles and abstracts, review full-text articles published in the English language and extract data, with discrepancies resolved by a third reviewer. Methodological quality and risk of bias of the included studies will be assessed using standardised tools. Primary outcomes are the prevalence and incidence of depression, anxiety and stress. Secondary outcomes include variations in the prevalence and incidence of these conditions based on sociodemographic factors, as well as associated risk factors that differ across regional contexts. Data will be pooled via meta-analysis where feasible or narratively synthesised if heterogeneity precludes quantitative synthesis. The systematic review will provide a comprehensive understanding of the burden of anxiety, depression and stress among older people in South-East Asia. This novel evidence will guide policymakers and healthcare practitioners in developing targeted interventions and generating essential evidence for supporting policy development in the region. ETHICS AND DISSEMINATION: Ethical approval will not be required as this study will not involve collection of original data. The findings will be disseminated through publications in a peer-reviewed journal and presentations at scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42024609033.