Li Yinglin, Lin Doudou, Gong Xuan, Fu Dou, Zhao Ling, Chen Weibing, Chen Jie, Liu Shanshan, Yang Guirong, Cai Zhongxiang
Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan, China.
Front Public Health. 2025 Mar 12;13:1495284. doi: 10.3389/fpubh.2025.1495284. eCollection 2025.
Depression and anxiety are prevalent mental health issues among older adult widowed adults. However, the symptom-level relationships between these conditions remain unclear. Due to the high correlations and complex relationships among various symptoms, this study employs network analysis to explore differences in the network structures of depression and anxiety symptoms between widowed and non-widowed older adults.
Propensity score matching was used to identify widowed older adults with similar demographic characteristics. Data from 1,736 widowed and 1,736 matched controls were analyzed using the Chinese Longitudinal Healthy Longevity Survey (2017-2018). Depression and anxiety were measured by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Central and bridge symptoms were evaluated using expected influence (EI) and bridge expected influence (BEI), respectively.
Network analysis revealed similarities in central symptoms between widowed and non-widowed older adults, with both groups exhibiting "Feeling depressed or down" (CESD3), "Feeling tense and having difficulty relaxing" (GAD4), and "Being unable to stop or control worrying" (GAD2) as core symptoms. However, differences emerged in bridge symptoms. In the widowed group, "Feeling anxious, worried, or distressed" (GAD1) was most strongly connected to "Felt lonely" (CESD8); "Worrying too much about various things" (GAD3) was strongly linked to "Feeling increasingly exhausted and useless with age" (CESD4); and "Feeling depressed or down" (CESD3) had a strong association with "Becoming easily annoyed or irritable" (GAD6). In the non-widowed group, "Feeling anxious, worried, or distressed" (GAD1) exhibited the strongest association with "Having good sleep quality" (CESD10); "Getting upset over small matters" (CESD1) was closely connected to "Feeling anxious, worried, or distressed" (GAD1); and "Worrying too much about various things" (GAD3) was most strongly connected to "Feeling depressed or down" (CESD3).
Common central and bridge symptoms highlight universal intervention targets. Addressing "Feeling depressed or down" in widowed and "Getting upset over small matters" in non-widowed older adults may help prevent depression-anxiety comorbidity. These findings support targeted interventions to improve mental health outcomes. Future research should evaluate tailored intervention effectiveness.
抑郁和焦虑是老年丧偶成年人中普遍存在的心理健康问题。然而，这些病症之间的症状水平关系仍不明确。由于各种症状之间存在高度相关性和复杂关系，本研究采用网络分析来探讨丧偶和非丧偶老年人抑郁和焦虑症状网络结构的差异。
倾向得分匹配用于识别具有相似人口统计学特征的丧偶老年人。使用中国老年健康影响因素跟踪调查（2017 - 2018）对1736名丧偶老年人和1736名匹配的对照的数据进行分析。抑郁和焦虑分别通过流行病学研究中心抑郁量表 - 10（CESD - 10）和七项广泛性焦虑障碍量表（GAD - 7）进行测量。中心症状和桥梁症状分别使用预期影响（EI）和桥梁预期影响（BEI）进行评估。
网络分析显示丧偶和非丧偶老年人在中心症状方面存在相似性，两组均表现出“感到沮丧或情绪低落”（CESD3）、“感到紧张且难以放松”（GAD4）以及“无法停止或控制担忧”（GAD2）作为核心症状。然而，在桥梁症状方面出现了差异。在丧偶组中，“感到焦虑、担忧或苦恼”（GAD1）与“感到孤独”（CESD8）联系最为紧密；“对各种事情过度担忧”（GAD3）与“随着年龄增长感到越来越疲惫和无用”（CESD4）紧密相连；“感到沮丧或情绪低落”（CESD3）与“变得容易生气或烦躁”（GAD6）有很强的关联。在非丧偶组中，“感到焦虑、担忧或苦恼”（GAD1）与“睡眠质量好”（CESD10）关联最强；“为小事烦恼”（CESD1）与“感到焦虑、担忧或苦恼”（GAD1）紧密相连；“对各种事情过度担忧”（GAD3）与“感到沮丧或情绪低落”（CESD3）联系最为紧密。
常见的中心症状和桥梁症状突出了普遍的干预靶点。解决丧偶老年人的“感到沮丧或情绪低落”以及非丧偶老年人的“为小事烦恼”可能有助于预防抑郁 - 焦虑共病。这些发现支持有针对性的干预措施以改善心理健康结果。未来的研究应评估量身定制的干预效果。
