Polysocial risk score and depressive symptoms in Chinese older adults: Evidence from network analyses

Depressive symptoms are influenced by multiple social factors, but their association with the polysocial risk score (PsRS) remains unclear. This study aimed to examine the association between PsRS and depressive symptoms, including its network structure.

Population-based cross-sectional study.

Jilin Province, China, from June to December 2025.

A total of 1740 older adults were included in the analysis.

PsRS was measured using 10 indicators across three domains: socioeconomic status, psychosocial factors, and living environment. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Logistic regression and network analyses were performed.

The prevalence of depressive symptoms among older adults was 33.85%. The participants with depressive symptoms had higher PsRS (4.49 ± 1.94) than those without (3.82 ± 1.89). Higher PsRS was associated with higher odds of depressive symptoms (OR = 1.21, 95% CI: 1.14-1.28). Compared with the low-PsRS group, the odds of depressive symptoms were higher in the moderate-PsRS and high-PsRS groups (moderate: OR = 1.57, 95% CI: 1.25-1.97; high: OR = 2.38, 95% CI: 1.71-3.32; P for trend < 0.001). Each of the three domains was significantly associated with depressive symptoms. Network analysis identified social isolation, psychosocial factors, and worthlessness as structurally important nodes.

Higher PsRS was associated with a greater likelihood of depressive symptoms. Social isolation and worthlessness played important roles in linking polysocial adversity to depressive symptoms.