Objective: The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods: We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results: Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.

Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer’s dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.

Objective: The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods: We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results: Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.

Objective: The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods: We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results: Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.

Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer’s dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.

Objective: The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods: We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results: Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.

Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer’s dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.

Objective: The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. Methods: We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. Results: Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). Conclusion This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.

Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer’s dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.