Depressive and anxiety symptoms among community-dwelling older adults with diverse self-perceptions of aging: a network analysis perspective.

OBJECTIVES: This study explored the network structure of depressive and anxiety symptoms among community-dwelling older adults, compared networks between those with more negative or positive self-perceptions of aging (SPA), and examined direct associations between SPA and depressive-anxiety. METHODS: A sample of 1,019 older adults from Xinxiang, China, was stratified by the Brief Aging Perceptions Questionnaire into more positive or negative group. Depression and anxiety symptoms were assessed via the PHQ-9 and GAD-7. Network centrality was measured using expected influence and bridge expected influence. RESULTS: In the more negative SPA network, "fatigue", "uncontrollable worry", and "feeling of worthlessness" showed the highest expected influence. In the more positive SPA network, central symptoms were "depressed or sad mood", "uncontrollable worry", and "worry too much". Flow network analysis identified strong positive correlations between SPA and symptoms including "afraid something will happen", "thoughts of death", and "feeling of worthlessness". CONCLUSION: This was the first study to compare depression-anxiety networks across older adults with more positive versus negative SPA and investigate their associations. Targeting central symptoms may effectively alleviate depression and anxiety. Moreover, intervening on symptoms strongly linked to SPA may offer a novel route for improving SPA.