Unveiling activating and specific bridge symptoms in older adults' psychosomatic networks by age and gender: A...

The objective of this study was to identify central symptoms, bridge symptoms, activating symptoms, and specific bridge symptoms, as well as to examine gender and age differences within mental health-chronic somatic disease networks.

We included 6426 older adults from the 2017/2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Depressive and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale-10 and the Generalized Anxiety Disorder Scale-7, respectively. Network analysis was employed to delineate central and bridge symptoms within the symptom networks, while the Bayesian network (BN) was utilized to identify activating symptoms and specific bridge symptoms as well as to explore gender and age differences.

Network analysis identified 'uncontrollable worry', 'trouble relaxing', 'nervousness or anxiety', and 'felt sadness' as primary central symptoms within the network, while 'nervousness or anxiety', 'bothered by things', 'sleep quality', and 'generalized worry' functioned as primary bridge symptoms. The BN identified that 'uncontrollable worry' and 'genitourinary system diseases' were activating symptoms, while 'everything was an effort' served as a specific bridge symptom. Although network analysis did not find significant differences by gender and age, the BN identified specific activating and bridge symptoms that varied across these subgroups.

These findings emphasize the necessity of tailored interventions targeting activating and specific bridge symptoms to enhance precise symptom management. Furthermore, it is imperative to adapt personalized intervention strategies according to the diverse needs of different gender and age groups.