Bridging late-life depression and chronic somatic diseases: a network analysis

Abstract

The clinical presentation of late-life depression is highly heterogeneous and likely influenced by the co-presence of somatic diseases. Using a network approach, this study aims to explore how depressive symptoms are interconnected with each other, as well as with different measures of somatic disease burden in older adults. We examined cross-sectional data on 2860 individuals aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, Stockholm. The severity of sixteen depressive symptoms was clinically assessed with the Comprehensive Psychopathological Rating Scale. We combined data from individual clinical assessment and health-registers to construct eight system-specific disease clusters (cardiovascular, neurological, gastrointestinal, metabolic, musculoskeletal, respiratory, sensory, and unclassified), along with a measure of overall somatic burden. The interconnection among depressive symptoms, and with disease clusters was explored through networks based on Spearman partial correlations. Bridge centrality index and network loadings were employed to identify depressive symptoms directly connecting disease clusters and depression. Sadness, pessimism, anxiety, and suicidal thoughts were the most interconnected symptoms of the depression network, while somatic symptoms of depression were less interconnected. In the network integrating depressive symptoms with disease clusters, suicidal thoughts, reduced appetite, and cognitive difficulties constituted the most consistent bridge connections. The same bridge symptoms emerged when considering an overall measure of somatic disease burden. Suicidal thoughts, reduced appetite, and cognitive difficulties may play a key role in the interconnection between late-life depression and somatic diseases. If confirmed in longitudinal studies, these bridging symptoms could constitute potential targets in the prevention of late-life depression.

The relationship between dimensions of empathy and symptoms of depression among university students during the COVID-19 pandemic: A network analysis

“…In the present study, we addressed this gap by showing specific associations between dimensions of empathy and symptoms of depression via network analysis. The findings add to the literature by showing that the related protective and risk factors differed considerably for symptoms of depression ( 49 – 55 ). Further, we calculated the bridge expected influence to detect influential nodes connecting dimensions of empathy and symptoms of depression.…”

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Recognizing Depression in the Elderly: Practical Guidance and Challenges for Clinical Management

“… 18 Suicidal thoughts are frequent in LLD, together with state of anxiety, especially in the morning. 19 …”

“…18 Suicidal thoughts are frequent in LLD, together with state of anxiety, especially in the morning. 19 What characterizes even more LLD is a shift towards somatic symptoms, 18 which become prominent and vary in their manifestations compared to early onset depression, although the criteria symptoms remain the same. For example, while increased appetite and overeating may frequently occur in younger individuals, loss of appetite and weight are more common in late life.…”

“…• Psychological stress in daily life 17 • Loss of social and supportive network 20 • Isolation 5,17 • Low emotional support from family members 17 • Loss of spouse 19 • Take care of relatives with chronic disease 18 • Having hobbies (for men) 27 • Being religious 28 • Physical activity 22 Cognitive-related factors…”