Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach

作者：Tianyin Liu, Man‐Man Peng, Frankie Ho Chun Wong, Dara Kiu Yi Leung, Wen Zhang, Gloria Hoi Yan Wong, Terry Yat Sang Lum · 发表于：Innovation in Aging · 年份：2023 · DOI：10.1093/geroni/igad075 · 被引用次数：5 · 研究领域：Mental Health Treatment and Access、Health disparities and outcomes、Digital Mental Health Interventions

Abstract Background and Objectives Depressive symptoms are common in older adults, and often co-occur with other mental health problems. However, knowledge about depressive symptom-domains and their associations with other conditions is limited. This study examined depressive symptom-domains and associations with anxiety, cognition, and loneliness. Research Design and Methods A sample of 3,795 participants aged 60 years and older were recruited from the community in Hong Kong. They were assessed for depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item), loneliness (UCLA 3-item), and cognition (Montreal Cognitive Assessment 5-Minute Protocol). Summary descriptive statistics were calculated, followed by confirmatory factor analysis of PHQ-9. Multiple Indicators Multiple Causes analysis was used to examine the associations between mental health conditions in the general sample and subgroups based on depressive symptom severity. Results A 4-factor model based on the Research Domain Criteria showed the best model fit of PHQ-9 (χ2/df = 10.63, Root-Mean-Square Error of Approximation = 0.05, Comparative Fit Index = 0.96, Tucker–Lewis Index = 0.93). After adjusting for demographics, 4 depressive symptom-domains were differentially associated with anxiety, loneliness, and cognition across different depression severity groups. The Negative Valance Systems and Internalizing domain (NVS-I; guilt and self-harm) were consistently associa...