Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis
Abstract Background Depressive symptoms, sleep disturbances, and frailty significantly affect older adults, representing a substantial public health issue. Although previous studies have demonstrated complex interrelationships among these factors, the underlying causal pathways and optimal intervent...
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| Format: | Article |
| Language: | English |
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BMC
2025-08-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-06273-1 |
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| _version_ | 1849234579952500736 |
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| author | Jia Fang Wenwen Wu Chen Yang Ni Zhang Yibo Wu Meifen Zhang |
| author_facet | Jia Fang Wenwen Wu Chen Yang Ni Zhang Yibo Wu Meifen Zhang |
| author_sort | Jia Fang |
| collection | DOAJ |
| description | Abstract Background Depressive symptoms, sleep disturbances, and frailty significantly affect older adults, representing a substantial public health issue. Although previous studies have demonstrated complex interrelationships among these factors, the underlying causal pathways and optimal intervention targets remain unclear. Objective The study aimed to elucidate the potential causal pathways linking these factors and identify optimal intervention targets to mitigate their synergistic effects. Methods A cross-sectional study was conducted in 2022 among 3,924 Chinese adults aged ≥ 60 years. Frailty was assessed using the FRAIL scale; sleep quality via the Brief Pittsburgh Sleep Quality Index; and depressive symptoms with the Patient Health Questionnaire-9. We employed network and Bayesian analyses to examine the interactions among these factors, focusing on identifying core and bridge symptoms and potential causal directions. Results Our findings indicate that illness (r s=2.30, r c=0.01, r b=24) has the greatest centrality, while fatigue (r BEI = 0.417) serves as the primary bridge symptom. Network comparison tests showed no significant differences in structure based on gender, age, or residence, suggesting uniformity across groups (p > 0.05). Sleep disturbances emerged as the most influential factor in the network, directly impacting both sleep quality and frailty. Conclusion This study uncovers the complex links between depressive symptoms, sleep quality, and frailty in older adults. Illness and fatigue are key symptoms, with sleep disturbances identified as a primary predictor affecting both sleep quality and frailty. Targeting sleep disturbances may alleviate frailty and enhance overall sleep health. |
| format | Article |
| id | doaj-art-ee878f78d3304f3cab6d12b4f09ea3f7 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj-art-ee878f78d3304f3cab6d12b4f09ea3f72025-08-20T04:03:06ZengBMCBMC Geriatrics1471-23182025-08-0125111510.1186/s12877-025-06273-1Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysisJia Fang0Wenwen Wu1Chen Yang2Ni Zhang3Yibo Wu4Meifen Zhang5School of Nursing, Sun Yat-Sen UniversitySchool of Nursing, Sun Yat-Sen UniversitySchool of Nursing, Sun Yat-Sen UniversitySchool of Nursing, Sun Yat-Sen UniversityDepartment of Nursing, International School of Medicine, the Fourth Affiliated Hospital of School of Medicine, International Institutes of Medicine, Zhejiang UniversitySchool of Nursing, Sun Yat-Sen UniversityAbstract Background Depressive symptoms, sleep disturbances, and frailty significantly affect older adults, representing a substantial public health issue. Although previous studies have demonstrated complex interrelationships among these factors, the underlying causal pathways and optimal intervention targets remain unclear. Objective The study aimed to elucidate the potential causal pathways linking these factors and identify optimal intervention targets to mitigate their synergistic effects. Methods A cross-sectional study was conducted in 2022 among 3,924 Chinese adults aged ≥ 60 years. Frailty was assessed using the FRAIL scale; sleep quality via the Brief Pittsburgh Sleep Quality Index; and depressive symptoms with the Patient Health Questionnaire-9. We employed network and Bayesian analyses to examine the interactions among these factors, focusing on identifying core and bridge symptoms and potential causal directions. Results Our findings indicate that illness (r s=2.30, r c=0.01, r b=24) has the greatest centrality, while fatigue (r BEI = 0.417) serves as the primary bridge symptom. Network comparison tests showed no significant differences in structure based on gender, age, or residence, suggesting uniformity across groups (p > 0.05). Sleep disturbances emerged as the most influential factor in the network, directly impacting both sleep quality and frailty. Conclusion This study uncovers the complex links between depressive symptoms, sleep quality, and frailty in older adults. Illness and fatigue are key symptoms, with sleep disturbances identified as a primary predictor affecting both sleep quality and frailty. Targeting sleep disturbances may alleviate frailty and enhance overall sleep health.https://doi.org/10.1186/s12877-025-06273-1Network analysisOlder adultsDepressive symptomsSleep qualityFrailty |
| spellingShingle | Jia Fang Wenwen Wu Chen Yang Ni Zhang Yibo Wu Meifen Zhang Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis BMC Geriatrics Network analysis Older adults Depressive symptoms Sleep quality Frailty |
| title | Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis |
| title_full | Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis |
| title_fullStr | Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis |
| title_full_unstemmed | Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis |
| title_short | Network relationships among depressive symptoms, sleep quality, and frailty in Chinese older adults: an undirected and bayesian network analysis |
| title_sort | network relationships among depressive symptoms sleep quality and frailty in chinese older adults an undirected and bayesian network analysis |
| topic | Network analysis Older adults Depressive symptoms Sleep quality Frailty |
| url | https://doi.org/10.1186/s12877-025-06273-1 |
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