Prevalence and Correlates of Problematic Alcohol Use Among Older Chinese Adults: A Study Combining Logistic Regression and Psychological Network Analysis

Background: Alcohol use inflicts substantial harm on older adults; however, research in China remains limited. The association between alcohol use and depression at the symptom level is particularly unclear. This study examined the prevalence and correlates of problematic alcohol use (PAU) and the network structure of comorbid PAU and depressive symptoms among older Chinese adults. Methods: A cross-sectional survey was conducted with 2643 adults aged ≥60 years in Wuhan, China. PAU was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9). Multivariate logistic regression identified correlates of PAU. A regularized partial correlation network was constructed to examine the comorbid structure of AUDIT and PHQ-9 symptoms. Results: The prevalence of any alcohol use was 21.0%, and that of PAU was 8.4%. Significant correlates of PAU included depressive symptoms (OR = 1.68, p = 0.004), male sex (OR = 2.87, p = 0.001), employment (OR = 1.51, p = 0.034), rural residence (OR = 1.51, p = 0.034), and lower monthly household income (0–56 USD vs. ≥490 USD: OR = 4.02, p = 0.020). In the network, the strongest edges were AUDIT–PHQ-1 “anhedonia” (edge weight = 0.272) and AUDIT–PHQ-3 “sleep disturbance” (edge weight = 0.183). Centrality indices revealed that PHQ-3 “sleep disturbance” and PHQ-1 “anhedonia” were the most central symptoms. Conclusions: Depressive symptoms were strongly associated with PAU among older Chinese adults. Male sex, employment, rural residence, and low income increased the risk. Anhedonia and sleep disturbance emerged as pivotal depressive symptoms bridging PAU. Interventions targeting reward processing and sleep regulation may mitigate this comorbidity.