Influencing factors and network analysis of depressive symptoms in middle-aged and elderly patients with chronic diseases accompanied by depression
LI Mingze
SHEN Aomei
LI Xin
WANG Jing
QI Weifang
ZHANG Zhang
WEN Xin
ZHANG Zhongning
QIANG Wanmin
Abstract：Objective:To investigate the influencing factors of depressive symptoms among middle-aged and elderly patients with chronic diseases accompanied by depression,to construct a symptom network to identify core and bridge symptoms,and to thereby enhance the effectiveness of interventions targeting depressive symptoms.Methods:Data were obtained from the 2020 China Health and Retirement Longitudinal Survey(CHARLS).Depression screening was conducted using Center for Epidemiologic Studies Depression Scale(CES-D).Linear regression analyses were conducted to identify significant predictors of depressive symptoms in this population.The subgroup symptom Network Comparison Test(NCT)package was employed to examine differences in symptom networks across subgroups.Results:A total of 4 874 middle-aged and elderly patients with chronic diseases accompanied by depression were included in the analysis,aged between 45 and 97 years old.Patients aged 60 years and above constituted 54.7%of the sample.The mean CES-D score was 15.73±4.64.The patient's gender,the number of chronic diseases,basic activities of daily living,alcohol consumption,exercise status,nighttime sleep duration,nap duration and social interaction status were the influencing factors of their depressive symptoms(P<0.05).Network analysis revealed that"feeling depressed"exhibited the highest strength centrality and closeness centrality,while"hopefulness about the future"demonstrated the highest betweenness and bridge centrality.There were no statistically significant differences in terms of network strength and overall structure among different subgroups(P>0.05).Conclusions:Depressive symptoms in middle-aged and elderly patients with chronic diseases accompanied by depression are highly interconnected."Feeling depressed"emerged as the core symptom,whereas"hopefulness about the future"served as a key bridging symptom.Gender,health status,and lifestyle factors were identified as significant determinants of depressive symptoms.These findings suggest that healthcare professionals may improve intervention outcomes by integrating knowledge of core symptoms,bridge symptoms,and relevant influencing factors into clinical practice.
Keywords：middle-aged and elderlychronic diseasesdepressionnetwork analysisinfluencing factors
Publication Date：2025-12-25
Online Publishing Date：2025-12-30(First online date of this platform, not the publication date of the document)
Pages：9( 4095-4103 )