["The world's largest aging population resides in China. Depressive disorders represent a public health problem among older adults in China; however, little is known about the course and natural outcomes with routine treatment in primary care.", 'We examined the one-year naturalistic course of depressive symptoms in older adult Chinese primary care patients (Hangzhou, China).', 'We found slight improvement among most of the older adults who initially presented with mild or subsyndromal depressive symptoms, but marked increase in severity in one group of initially mildly depressed older adults; a lack of improvement among all older adults with severe initial presentations. Greater physical illness burden, lower functional capacity, and lower family support were associated with greater initial depressive symptom severity and lack of improvement over time.'] Is course of late-life depression in China chronic and unremitting?