A network analysis of depressive symptoms and cognitive performance in older adults with multimorbidity: A nationwide...

Depression and cognitive impairment are prevalent mental health issues. Older adults in China exhibits a higher prevalence of multimorbidity, which is linked to an increased risk of depression and cognitive impairment. This study aims to investigate association between depressive symptoms and cognitive impairment in older adults with multimorbidity using network analysis, and to identify important bridge symptoms as potential intervention targets.

The study included 5729 individuals aged 60 years and above with multimorbidity, drawn from the China Health and Retirement Longitudinal Survey (CHARLS) dataset. Depressive symptoms and cognitive performance were assessed utilizing the CESD-10 (10-item Center for Epidemiologic Studies Depression) and MMSE (Mini Mental State Examination) scales, respectively. We constructed a network structure of depressive symptoms and cognitive performance, and calculated index of strength and bridge strength for each symptom. Furthermore, a comparative analysis of the network structure across gender and age groups were conducted.

D3 (Felt depressed), C1 (Orientation), and D10 (Could not get going) were identified as the central symptoms of the depressive symptoms - cognitive performance network. C1 (Orientation), C5 (Linguistic skills), and D10 (Could not get going) were bridge symptoms connecting the two illnesses. Moreover, significant differences in edge weights were observed across gender and age groups.

The central symptoms and bridge symptoms in the network may represent the most effective intervention pathway for addressing cognitive impairment and depression in older adults with multimorbidity. Clinical interventions should properly focus on gender and age differences in symptom presentation.