{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:52:15Z","timestamp":1780347135740,"version":"3.54.1"},"reference-count":108,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Depression and anxiety are prevalent mental health issues among older adult widowed adults. However, the symptom-level relationships between these conditions remain unclear. Due to the high correlations and complex relationships among various symptoms, this study employs network analysis to explore differences in the network structures of depression and anxiety symptoms between widowed and non-widowed older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Propensity score matching was used to identify widowed older adults with similar demographic characteristics. Data from 1,736 widowed and 1,736 matched controls were analyzed using the Chinese Longitudinal Healthy Longevity Survey (2017\u20132018). Depression and anxiety were measured by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Central and bridge symptoms were evaluated using expected influence (EI) and bridge expected influence (BEI), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Network analysis revealed similarities in central symptoms between widowed and non-widowed older adults, with both groups exhibiting \u201cFeeling depressed or down\u201d (CESD3), \u201cFeeling tense and having difficulty relaxing\u201d (GAD4), and \u201cBeing unable to stop or control worrying\u201d (GAD2) as core symptoms. However, differences emerged in bridge symptoms. In the widowed group, \u201cFeeling anxious, worried, or distressed\u201d (GAD1) was most strongly connected to \u201cFelt lonely\u201d (CESD8); \u201cWorrying too much about various things\u201d (GAD3) was strongly linked to \u201cFeeling increasingly exhausted and useless with age\u201d (CESD4); and \u201cFeeling depressed or down\u201d (CESD3) had a strong association with \u201cBecoming easily annoyed or irritable\u201d (GAD6). In the non-widowed group, \u201cFeeling anxious, worried, or distressed\u201d (GAD1) exhibited the strongest association with \u201cHaving good sleep quality\u201d (CESD10); \u201cGetting upset over small matters\u201d (CESD1) was closely connected to \u201cFeeling anxious, worried, or distressed\u201d (GAD1); and \u201cWorrying too much about various things\u201d (GAD3) was most strongly connected to \u201cFeeling depressed or down\u201d (CESD3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Common central and bridge symptoms highlight universal intervention targets. Addressing \u201cFeeling depressed or down\u201d in widowed and \u201cGetting upset over small matters\u201d in non-widowed older adults may help prevent depression-anxiety comorbidity. These findings support targeted interventions to improve mental health outcomes. Future research should evaluate tailored intervention effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1495284","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T05:18:06Z","timestamp":1741756686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Inter-relationships of depression and anxiety symptoms among widowed and non-widowed older adults: findings from the Chinese Longitudinal Healthy Longevity Survey based on network analysis and propensity score matching"],"prefix":"10.3389","volume":"13","author":[{"given":"Yinglin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doudou","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dou","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guirong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxiang","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"ref1","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1370359","DOI":"10.3389\/fpubh.2024.1370359","article-title":"Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study","volume":"12","author":"Ma","year":"2024","journal-title":"Front Public Health"},{"key":"ref3","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1186\/s12877-023-04168-7","article-title":"Social participation, psychological resilience and depression among widowed older adults in China","volume":"23","author":"Li","year":"2023","journal-title":"BMC Geriatr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1257133","DOI":"10.3389\/fpubh.2023.1257133","article-title":"Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis","volume":"11","author":"Zhang","year":"2023","journal-title":"Front Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1037\/0003-066X.44.3.513","article-title":"Conservation of resources. 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