Latent Profile Subtypes of Depressive Symptoms and Associated Factors Among Elderly Patients with Chronic Heart Failure

Objective: To identify latent subtypes of depressive symptoms and their associated factors among elderly patients with chronic heart failure (CHF), so as to provide reference for developing targeted psychological intervention strategies. Methods: A cross-sectional survey enrolled 423 hospitalized elderly CHF patients from June 2025 to May 2026. Assessments included SDS, SAS, Family APGAR, MLHFQ and PNI. Different from conventional SDS total-score-based severity grouping, latent profile analysis (LPA) was performed based on item-level responses of the Self-Rating Depression Scale (SDS) to derive depressive symptom profiles. Univariate tests and multinomial logistic regression were used to examine variables associated with profile membership. Results: Three depressive-symptom latent profiles were identified from SDS item-level data, which largely followed a mild-to-moderate-to-severe symptom gradient: mild low-symptom type (50.35%), moderate emotion-predominant type (34.52%), severe somatic-cognitive type (15.13%). NYHA class III (OR=2.444, 95% CI: 1.238– 4.823) / IV (OR=4.301, 95% CI: 1.814– 10.196), living alone (OR=2.887, 95% CI: 1.630– 5.113), and malnutrition (OR=1.775, 95% CI: 1.022– 3.082) were independently associated with membership in the moderate emotion-predominant profile. Widowhood/divorce (OR=9.226, 95% CI: 2.695– 31.586), polypharmacy (≥ 6 drugs) (OR=5.856, 95% CI: 1.295– 26.472), and severe anxiety (OR=4.911, 95% CI: 1.275– 18.921) were exclusive associated factors for the severe somatic-cognitive profile. Advanced cardiac dysfunction, solitary living and family dysfunction elevated odds for both moderate and severe profiles; mild anxiety (OR=0.183, 95% CI: 0.036– 0.932) and moderate quality of life (OR=0.069, 95% CI: 0.006– 0.758) were associated with lower odds of belonging to the severe-symptom profile. Conclusion: Depressive symptoms among elderly CHF patients show obvious heterogeneity and present an overall mild-to-moderate-to-severe symptom gradient. Our findings highlight potential high-risk groups (solitary-living patients, malnourished patients, patients with severe cardiac dysfunction and poor family support). These observational results may inform future development of stratified psychological-intervention approaches, although intervention effectiveness was not evaluated in the present cross-sectional study.