{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T02:11:33Z","timestamp":1767924693507,"version":"3.49.0"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Hong Kong Jockey Club Charities Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Depressive symptoms are common in older adults, and often co-occur with other mental health problems. However, knowledge about depressive symptom-domains and their associations with other conditions is limited. This study examined depressive symptom-domains and associations with anxiety, cognition, and loneliness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>A sample of 3,795 participants aged 60 years and older were recruited from the community in Hong Kong. They were assessed for depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item), loneliness (UCLA 3-item), and cognition (Montreal Cognitive Assessment 5-Minute Protocol). Summary descriptive statistics were calculated, followed by confirmatory factor analysis of PHQ-9. Multiple Indicators Multiple Causes analysis was used to examine the associations between mental health conditions in the general sample and subgroups based on depressive symptom severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A 4-factor model based on the Research Domain Criteria showed the best model fit of PHQ-9 (\u03c72\/df = 10.63, Root-Mean-Square Error of Approximation = 0.05, Comparative Fit Index = 0.96, Tucker\u2013Lewis Index = 0.93). After adjusting for demographics, 4 depressive symptom-domains were differentially associated with anxiety, loneliness, and cognition across different depression severity groups. The Negative Valance Systems and Internalizing domain (NVS-I; guilt and self-harm) were consistently associated with anxiety (\u03b2 = 0.45, 0.44) and loneliness (\u03b2 = 0.11, 0.27) regardless of depression severity (at risk\/mild vs moderate and more severe, respectively, all p &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>The consistent associations between the NVS-I domain of depression with anxiety and loneliness warrant attention. Simultaneous considerations of depressive symptom-domains and symptom severity are needed for designing more personalized care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration Number<\/jats:title>\n                  <jats:p>NCT03593889<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geroni\/igad075","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T13:13:02Z","timestamp":1689772382000},"source":"Crossref","is-referenced-by-count":5,"title":["Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-5342","authenticated-orcid":false,"given":"Tianyin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Social Work and Social Administration , , Hong Kong , China"},{"name":"The University of Hong Kong , , Hong Kong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man-Man","family":"Peng","sequence":"additional","affiliation":[{"name":"Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University , Zhuhai , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9072-769X","authenticated-orcid":false,"given":"Frankie H C","family":"Wong","sequence":"additional","affiliation":[{"name":"Philip Merrill College of Journalism, University of Maryland , College Park, Maryland , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7255-2790","authenticated-orcid":false,"given":"Dara K Y","family":"Leung","sequence":"additional","affiliation":[{"name":"Sau Po Centre on Ageing, The University of Hong Kong , Hong Kong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8166-2879","authenticated-orcid":false,"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Studies, Hong Kong Metropolitan University , Hong Kong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-942X","authenticated-orcid":false,"given":"Gloria H Y","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Social Work and Social Administration , , Hong Kong , China"},{"name":"The University of Hong Kong , , Hong Kong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry Y S","family":"Lum","sequence":"additional","affiliation":[{"name":"Department of Social Work and Social Administration , , Hong Kong , China"},{"name":"The University of Hong Kong , , Hong Kong , China"},{"name":"Sau Po Centre on Ageing, The University of Hong 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