Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 30:16:1596015.
doi: 10.3389/fpsyt.2025.1596015. eCollection 2025.

The relationship between frailty in older adults and anxiety and depression in china: propensity score matching and network analysis

Yinglin Li #  1 , Ling Zhao #  1 , Doudou Lin  2 , Xinmei Wang  2 , Chunlong Zhang  1 , Jiali Zhou  1 , Zhongxiang Cai  1
Affiliations

The relationship between frailty in older adults and anxiety and depression in china: propensity score matching and network analysis

Yinglin Li et al. Front Psychiatry. .

Abstract

Objective: Anxiety and depression are common mental disorders in the elderly. Concurrent frailty may lead to worse clinical outcomes. This study examined the network structures of anxiety and depression in frail and non-frail older adults.

Methods: The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to measure depressive and anxiety symptoms, respectively. Following propensity score matching (PSM), 877 frail elderly individuals were matched with 877 non-frail elderly individuals. Central (influential) and bridge symptoms were estimated using the expected influence (EI) and bridge expected influence (bridge EI), respectively. Network stability was assessed using the case-dropping bootstrap method.

Results: Based on the NCT results, there were no significant differences in the comparison of the network models between the non-frailty group and the frailty group in terms of global strength (7.175 vs. 7.136, S = 0.039, P = 0.802) and network structure (M = 0.137, P = 0.703). There were also no significant differences in edge weights between the networks of the two groups (P > 0.05).

Conclusion: NCT results showed no significant difference in the network structure of anxiety and depression between frail elderly and control groups. A slight decrease in network strength was observed in non-frail elderly but was not statistically significant. Both groups showed similar characteristics in bridging symptoms, central symptoms, overall strength, and network structure. Interventions for anxiety and depression are equally beneficial for both frail and non-frail elderly.

Keywords: anxiety; depression; frailty; network analysis; older adults.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The network structure of anxiety and depression in frail and non-frail elderly people.
Figure 2
Figure 2
The standardized value (z-score) of EI for each node in the frailty and non-frailty groups.
Figure 3
Figure 3
Bridge centrality indices (z-score) of the non-frailty and frailty groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ma W. ulletin on the Development of National Aging Affairs in 2022 - Departmental Updates - The People’s Government of the People’s Republic of China [WWW document] (2022). Available online at: https://www.gov.cn/lianbo/bumen/202312/content_6920261.htm (Accessed 11.12.24).
    1. Tang T, Jiang J, Tang X. Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis. J Affect Disord. (2021) 293:379–90. doi: 10.1016/j.jad.2021.06.050 - DOI - PubMed
    1. Zhang H-H, Jiang Y-Y, Rao W-W, Zhang Q-E, Qin M-Z, Ng CH, et al. Prevalence of depression among empty-nest elderly in China: A meta-analysis of observational studies. Front Psychiatry. (2020) 11:608. doi: 10.3389/fpsyt.2020.00608 - DOI - PMC - PubMed
    1. Gosselin P, Castonguay C, Goyette M, Lambert R, Brisson M, Landreville P, et al. Anxiety among older adults during the COVID-19 pandemic. J Anxiety Disord. (2022) 92:102633. doi: 10.1016/j.janxdis.2022.102633 - DOI - PMC - PubMed
    1. Xie Q, Xu Y-M, Zhong B-L. Anxiety symptoms in older Chinese adults in primary care settings: Prevalence and correlates. Front Public Health. (2022) 10:1009226. doi: 10.3389/fpubh.2022.1009226 - DOI - PMC - PubMed

LinkOut - more resources