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

## TL;DR

This study explores whether frailty in older adults affects the network structure of anxiety and depression symptoms in China, finding no significant differences between frail and non-frail groups.

## Contribution

The novel contribution is using network analysis and propensity score matching to compare mental health symptom structures in frail and non-frail older adults.

## Key findings

- No significant differences in network structure of anxiety and depression between frail and non-frail elderly.
- Both groups showed similar central and bridging symptoms in their mental health networks.
- Interventions for anxiety and depression are equally relevant for frail and non-frail older adults.

## Abstract

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.

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.

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).

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.