A latent profile analysis and network analysis of depression and anxiety symptoms among older adults living alone

Abstract

Living alone is a well-recognized risk factor in aging, associated with adverse psychological outcomes including depression and anxiety. However, the heterogeneity of depression-anxiety comorbidity patterns and inter-symptom relationships remain understudied in older adults living alone. A total of 11,632 adults aged ≥ 60 years were included from the 2018 Chinese Longitudinal Healthy Longevity Survey. Depressive and anxiety symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CESD-10) and Generalized Anxiety Disorder Scale (GAD-7), respectively. LPA identified symptom profiles among older adults living alone, and network analysis was conducted to identify core symptoms in each identified subgroup. Among older adults living alone, LPA identified a low-risk class and a high-risk class. In the high-risk network, sadness (CESD3), nervousness or anxiety (GAD1), and uncontrollable worry (GAD2) had the highest expected influence. Global strength and overall network structure did not differ significantly between classes, whereas six individual edges differed. This study deeply explores the comorbidity patterns of internal subgroups among older adults living alone, providing a theoretical basis and potential targets for intervention in the comorbidity of depression and anxiety symptoms in this population.