A Network Analysis of Depressive Symptoms and Cognitive Functions Among Older Adults Distressed by Body Pain: Findings From a National China Survey

Background Body pain is common among older adults who often experience comorbid depressive symptoms and cognitive impairments. This study examined differences in depressive symptoms and cognitive functions between older adults distressed with body pain and those without pain and explored symptom interrelationships in the pain-distressed group. Methods Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale-10 (CESD-10). Cognitive function was evaluated using standardized measures. Network analysis identified both central and bridge symptoms in the pain group. Results This study included 3938 participants of whom 1969 comprised the group distressed by body pain. Depressive symptoms were more prevalent among those with body pain (39.1%; 95% CI: 36.95%, 41.25%]) compared to controls (21.4%; 95% CI: 19.59%, 23.21%], P < 0.01). Conversely, cognitive function scores did not differ between the two groups. In the network model for the pain-distressed group, “feeling depressed” (CESD3) was the most central symptom (strength = 1.01), followed by “everything was an effort” (CESD4) (strength = 0.98) and “inability to get going” (CESD10) (strength = 0.88). “Orientation” (Bridge strength = 1.44) was the most influential bridge symptom linking depressive symptom and cognitive function communities, followed by “memory” (Bridge strength = 1.13) and “attention” (Bridge strength = 0.72). Conclusion Findings highlighted a higher prevalence of depressive symptoms among older adults with body pain compared to their pain-free peers. Results suggest interventions targeting key central and bridge symptoms warrant consideration in future treatment studies.