To identify reproducible depressive symptom patterns in older adults and test whether these patterns add information beyond CES-D total score.
Approach:
Cohorts: Utilized the Health and Retirement Study (HRS) as the discovery cohort and the English Longitudinal Study of Ageing (ELSA) as the independent replication cohort.
Methodology: Conducted latent class analysis (LCA) to derive symptom patterns and evaluated cross-cohort structural replication, baseline external validity, and longitudinal associations.
Key Findings:
Identified a 4-class solution: Minimal Symptoms, Somatic-Motivational, Affective-Social, and Global Distress.
The Somatic-Motivational pattern showed higher odds of future elevated depressive symptom status (OR, 1.39; 95% CI, 1.22-1.58 in ELSA; OR, 1.53; 95% CI, 1.41-1.65 in HRS) and increased risk of ADL worsening and mortality in both cohorts.
Adding symptom patterns to score-only models improved likelihood-based fit across outcomes.
Interpretation:
Reproducible depressive symptom patterns can be identified across two national ageing cohorts.
Limitations:
The study relies on self-reported data, which may introduce bias.
Findings may not be generalizable to all older adult populations due to cohort-specific characteristics.
Conclusion:
Symptom configuration provides a complementary layer of late-life risk assessment.
