Network Analysis Revealed the Role of Helplessness as a Central Feature Among Late-Life Depressive Symptoms in Patients With Mild Cognitive Impairment and Early Stage Dementia

Abstract

Objective It has been reported that depressive symptoms in older adults are different from those in younger adults, especially when accompanied by cognitive decline. However, few studies have investigated the network structure of depressive symptoms in this population.Methods The participants consisted of 627 older adults (>60 yr) who were diagnosed with mild cognitive impairment (MCI) or early stage dementia. Among them, 36.7% were male and the mean age was 76.20±7.71 years. The Korean form of Geriatric Depression Scale (KGDS) was used to evaluate their depressive symptoms and network analyses were performed using bootnet R-package to identify the central features among depressive symptoms.Results Of all the KGDS items, we found that KGDS 2 (often feel helpless) had the highest node strength followed by KGDS 21 (in good spirits), KGDS 14 (not confident at all), and KGDS 15 (cheerful and happy). In terms of node betweenness, KGDS 2 also showed the highest value. The edge weights of edges connected to node KGDS 2 were strongest in KGDS 3 (restless and fidgety) and KGDS 28 (easily get tired).Conclusion In this study, we presented which symptoms are central among the elderly with MCI and early stage dementia. This result not only increases the understanding of depressive symptoms in this group but would also help determine target symptoms in the treatment program.