Chen Wenqin, Zhao Xin, Xu Tao, Fang Linghui, Hong Chen, Xie Yiqian, Yan Weiman, Zhou Xiaolu, He Yang
School of Education, Shanghai Normal University, Shanghai, China.
Teacher Education College, Hunan City University, Yiyang, Hunan, China.
Front Psychiatry. 2025 May 28;16:1576964. doi: 10.3389/fpsyt.2025.1576964. eCollection 2025.
With the rapid aging of China's population, the proportion of older adults living alone has increased significantly, bringing their mental health concerns into sharp focus. This study aims to explore the network structure of anxiety and depressive symptoms among older Chinese adults who live alone, thereby identifying central and bridging symptoms to provide scientific evidence for potential intervention targets in prevention and treatment.
A total of 1,952 older Chinese adults, aged 65 and older, living alone, were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2017-2018. We assessed anxiety and depressive symptoms using Generalized Anxiety Disorder Scale (GAD-7) and the Center for Epidemiologic Studies Depression Scale (CES-D). We identified central and bridge symptoms via expected influences (EI) and bridge expected influences (BEI); network stability was evaluated using bootstrap methods.
The network structure uncovered four crucial connections between anxiety and depressive symptoms. GAD4 "Trouble relaxing", GAD2 "Uncontrollable worry", and CESD3 "Feeling blue/depressed" exhibited the highest EI values within the network. Meanwhile, GAD1 "Nervousness or anxiety" and CESD10 "Sleep disturbances" showed the highest BEI values within their respective communities.
This exploratory study is the first to examine the reciprocal relationship between depressive and anxiety symptoms in older Chinese adults living alone. Targeting these central and bridging symptoms may effectively prevent comorbidity and facilitate targeted interventions for those at risk or currently experiencing these symptoms.
随着中国人口的快速老龄化，独居老年人的比例显著增加，他们的心理健康问题成为人们关注的焦点。本研究旨在探讨中国独居老年人焦虑和抑郁症状的网络结构，从而确定核心症状和桥梁症状，为预防和治疗中的潜在干预靶点提供科学依据。
从2017 - 2018年进行的中国健康与养老追踪调查（CLHLS）中选取了1952名65岁及以上的中国独居老年人。我们使用广泛性焦虑障碍量表（GAD - 7）和流行病学研究中心抑郁量表（CES - D）评估焦虑和抑郁症状。我们通过预期影响（EI）和桥梁预期影响（BEI）确定核心症状和桥梁症状；使用自助法评估网络稳定性。
该网络结构揭示了焦虑和抑郁症状之间四个关键的联系。GAD4“难以放松”、GAD2“无法控制的担忧”以及CESD3“情绪低落/沮丧”在网络中表现出最高的EI值。同时，GAD1“紧张或焦虑”和CESD10“睡眠障碍”在各自的群落中表现出最高的BEI值。
这项探索性研究首次考察了中国独居老年人抑郁和焦虑症状之间的相互关系。针对这些核心症状和桥梁症状可能有效地预防共病，并为那些有风险或目前正在经历这些症状的人提供有针对性的干预措施。
