Network analysis of sleep disorders, depression and anxiety symptoms among community older adults

BMC Geriatr. 2025 Sep 24;25(1):694. doi: 10.1186/s12877-025-06381-y.

ABSTRACT

BACKGROUND: Sleep disorders, depression, and anxiety are emerging as significant public health concerns among the aging population worldwide, and they are highly interrelated with each other. We aim to identify key symptoms and shed light on a deeper understanding of the intricate connections between symptoms of sleep disorders, depression and anxiety.

METHODS: This study used multistage sampling to select 18 residential areas in Jinjiang District, Chengdu City, Sichuan Province, China from December 2017 to April 2018. A total of 434 urban community-dwelling older adults aged 60 or above were recruited. The item scores of the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure the participants’ symptoms of sleep disorders, depression and anxiety, respectively. The statistical analysis employed network analyses as the primary methodology.

RESULTS: Within the realm of depressive symptoms, “Suicidality” showed the strongest link with “Worthlessness” (weight = 0.23). In terms of cross-disorders connections, “Disturbed sleep” in depression displayed a close relationship with “Sleep latency” in sleep disorders (weight = 0.32). However, no strong connection was observed between anxiety and sleep disorders. Furthermore, the symptoms “Fatigue” and “Sleep difficulties ” had the highest strength centrality (z > = 1).

CONCLUSIONS: The central symptoms and their intricate connections in the network play an importance role in gaining the underlying pathological mechanisms, as well as potential interventions for comorbidity in community older adults.

PMID:40993514 | DOI:10.1186/s12877-025-06381-y