1. College of Education for the Future, Beijing Normal University, China.
2. Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
3. Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
4. Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
5. School of Nursing, Tung Wah College, Hong Kong SAR, China.
6. School of Public Health, Southeast University, Nanjing, China.
7. Center for Global Health Equity, New York University (Shanghai), Shanghai, China.
8. School of Global Public Health, New York University, NY, USA.
9. School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
10. Department of Geriatric Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
11. Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
Background: The 2019 novel coronavirus disease (COVID-19) outbreak had a detrimental impact on the mental health of older adults. This study evaluated the central symptoms and their associations in the network of depressive symptoms and compared the network structure differences between male and female older adults in Hong Kong.
Methods: Altogether, 3,946 older adults participated in this study. We evaluated the centrality indicators for network robustness using stability and accuracy tests, and examined the potential differences between the structure and connectivity of depression networks in male and female older adults.
Results: The overall prevalence of depressive symptoms was 43.7% (95% CI=40.6-46.7%) in males, and 54.8% (95% CI=53.1-56.5%) in females (P<0.05). Sad Mood, Guilt, Motor problems and Lack of Energy were influential symptoms in the network model. Gender differences were found in the network global strength, especially in the following edges: Sad Mood--Guilt, Concentration--Guilt, Anhedonia--Motor, Lack of Energy--Suicide, Appetite--Suicide and Concentration--Suicide.
Conclusions: Central symptoms in the depressive symptom network among male and female older adults may be prioritized in the treatment and prevention of depression during the pandemic.
Keywords: older adults, depression, network analysis, COVID-19, Hong Kong