Network analysis of the association between depression and quality of life in the elderly

The worsening global aging population and the rising prevalence of depression occur simultaneously. However, the mechanisms through which depression affects quality of life (QOL) in different domains remain poorly understood, particularly in older adults. Data for this research were sourced from the Healthy Aging Cross-Sectional Data. To assess depression symptoms and QOL, the Geriatric Depression Scale (GDS-15) and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) were utilized, respectively. The analysis sought to evaluate the influence of depression on QOL by examining central and bridging symptoms within the network and their connections to QOL. A total of 2,520 participants were included in this survey, of which 581 (23.1%) screened positive for depression (GDS-15 ≥ 5). From the analyses of global network comparison, we found that the networks appeared to differ between the non-depressed and depressed groups both before (M = 0.208, p = 0.022, S = 0.526, p = 0.422) and after (M = 0.216, p = 0.036, S = 0.091, p = 0.806) propensity score matching (PSM). Within the derived depression-QOL network, we identified that the 10 strongest edges between the two communities are distributed across the respective domains of QOL. Notably, GDS1 (Life satisfaction), GDS5 (Happiness), and GDS4 (Boredom) serve as bridge symptoms within the depression-QOL network. The indicator of 'a general sense of satisfaction with life' was crucial in the network of symptoms, demonstrating notable links to the QOL of the residents. Vigilance towards these symptoms is vital for reducing risks and preventing the worsening of QOL in the elderly.