Depression and anxiety symptom networks across the lifespan

The relationship between anxiety and depressive symptoms is complex and may vary across the lifespan. Symptom network analyses offer a powerful tool to examine these interactions, but few studies have directly compared symptom networks in younger and older adults.

We analysed data from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study, including 786 participants aged 18 to 88, who reported at least subclinical levels of symptoms on the Hospital Anxiety and Depression Scale (HADS). Network analysis was employed to examine symptom communities (clusters of related symptoms), within- and between-community connectivity (association strength), and centrality (symptom importance) across age groups.

The overall network structure, separating anxiety and depressive symptoms into two communities, remained stable. However, older adults showed reduced connectivity within depression and between depression and anxiety. While 'panic' was a consistently central symptom, 'rumination' and 'restlessness' were the key bridge symptoms (i.e. linking anxiety and depression) in young and older adults, respectively.

Our findings reveal both stable and dynamic aspects of depression and anxiety symptoms across the lifespan. Reduced within-community connectivity for depressive symptoms suggests greater heterogeneity in how depression manifests in older populations. The shift in bridging symptoms, from cognitive (rumination) in young adults to somatic (restlessness) in older adults, suggests subtle yet clinically important differences in how depression and anxiety are linked across the lifespan. Our findings support age-informed assessment and diagnosis of depressive and anxiety symptoms.