Depressive symptoms and sarcopenia risk in older adults with diabetes: a network analysis approach to understanding comorbidity

Depressive symptoms and sarcopenia are prevalent and strongly interrelated in older adults with diabetes. This study aimed to examine the association between depressive symptoms and sarcopenia risk using network analysis and to identify central and bridge symptoms that may serve as potential targets for intervention. This multicenter, cross-sectional study included 716 older adults with diabetes. Depressive symptoms and sarcopenia risk were assessed using the 5-item Geriatric Depression Scale (GDS-5) and the 6-item SARC-CalF scale, respectively. A symptom-level network was constructed, and indices of node strength and bridge strength were calculated. Exploratory subgroup analyses examined networks stratified by age, sex, and diabetes duration. Network Comparison Tests assessed differences in overall network structure and global strength. The network model revealed that D1 (Life dissatisfaction, node strength = 3.081), D5 (Feel worthless, node strength = 2.545), and S2 (Assistance in walking, node strength = 2.403) were the central symptoms in the depressive symptom-sarcopenia risk network. D1 (Life dissatisfaction, bridge strength = 1.889) and D5 (Feel worthless, bridge strength = 1.775) emerged as bridge symptoms linking the two conditions. Exploratory subgroup analyses revealed variations in central and bridge symptoms across sex, age, and diabetes duration. “Life dissatisfaction,” “Feel worthless,” and “Assistance in walking” showed the highest node strength, with the first two also showing the highest bridge strength. These findings highlight prominent symptoms within the network and characterize the associations between depressive symptoms and sarcopenia risk in older adults with diabetes. Not applicable.