{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:09:20Z","timestamp":1788995360187,"version":"build-2803163510"},"reference-count":34,"publisher":"Korean Neuropsychiatric Association","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Brain Science and Brain-like Intelligence Technology-National Science and Technology Major Project","award":["2021ZD0200600"],"award-info":[{"award-number":["2021ZD0200600"]}]},{"name":"Qingdao Medical and Health Research Project","award":["2025-WJKY117"],"award-info":[{"award-number":["2025-WJKY117"]}]},{"name":"Qingdao Medical and Health Research Project","award":["2025-WJKY120"],"award-info":[{"award-number":["2025-WJKY120"]}]}],"content-domain":{"domain":["psychiatryinvestigation.org"],"crossmark-restriction":true},"short-container-title":["Psychiatry Investig"],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:p>Objective To identify patterns of chronic disease multimorbidity in older Chinese adults, examine variables associated with the link between multimorbidity and depression, and characterize depressive symptom network features. Methods We analyzed cross-sectional data from the China Health and Retirement Longitudinal Study including 2,117 adults aged \u226560 years. Fourteen physician-diagnosed chronic conditions were subjected to exploratory factor analysis to identify latent multimorbidity clusters. Logistic regression was used to examine correlates of depression. For each cluster, Mixed Graphical Models estimated partial correlations among depressive symptoms assessed by the 10-item Center for Epidemiologic Studies Depression Scale and selected correlates, with centrality and bridge indices computed to characterize network structure. Results Tetrachoric factor analysis identified two stable clusters\u2014a metabolic\u2013vascular cluster (hypertension, dyslipidemia, diabetes, stroke) and a visceral\u2013neurodegenerative cluster (liver disease, kidney disease, arthritis, memory-related disorders). Ten variables were significantly associated with depression (area under the curve=0.734, 95% confidence interval 0.708\u20130.793), with cognitive impairment showing the strongest association. Network analyses indicated that effort-related and motivational symptoms were central across clusters, whereas cognitive impairment consistently exhibited the highest bridge strength linking multimorbidity-related factors and depressive symptoms. Conclusion Multimorbidity in older adults forms clinically meaningful clusters associated with distinct depressive symptom network characteristics. Cognitive impairment emerged as the most prominent bridge-related correlate. Findings are associative and hypothesisgenerating. Longitudinal and interventional studies are warranted.<\/jats:p>","DOI":"10.30773\/pi.2026.0076","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T07:18:31Z","timestamp":1788247111000},"page":"1208-1217","update-policy":"https:\/\/doi.org\/10.30773\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimorbidity Clusters and Depressive Symptom Networks in Old Age: Evidence From China"],"prefix":"10.30773","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3155-7480","authenticated-orcid":true,"given":"Xin","family":"Guan","sequence":"first","affiliation":[{"name":"Qingdao University Medical College, Qingdao, China"},{"name":"Qingdao Mental Health Center, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3082-1697","authenticated-orcid":true,"given":"Li-gang","family":"Wang","sequence":"additional","affiliation":[{"name":"Qingdao Mental Health Center, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2235-4298","authenticated-orcid":true,"given":"Zhen-jing","family":"Liu","sequence":"additional","affiliation":[{"name":"Qingdao Mental Health Center, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9924-8203","authenticated-orcid":true,"given":"Yan-kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Qingdao Mental Health Center, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8841-5750","authenticated-orcid":true,"given":"Xin-mei","family":"Hao","sequence":"additional","affiliation":[{"name":"Qingdao Mental Health Center, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4173-2173","authenticated-orcid":true,"given":"Xin-yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Shenzhen Kangning Hospital, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6265-7903","authenticated-orcid":true,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Qingdao Endocrine & Diabetes Hospital, Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1565-2872","authenticated-orcid":true,"given":"Ping","family":"Sun","sequence":"additional","affiliation":[{"name":"Qingdao Mental Health Center, Qingdao, 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