Which Depressive Symptoms Really Matter in Older Adults? A Landmark Review

A landmark systematic review in Translational Psychiatry mapped which depressive symptoms are most central in psychological symptom networks for people aged 50 and older. Led by Stephanie Ming Yin Wong of The University of Hong Kong, the team searched PubMed, PsycINFO, and Web of Science from inception through February 15, 2025, adding one additional study found during peer review. The final set included 57 studies with 176 symptom networks built using 17 different depression scales. Using centrality measures such as expected influence or bridge centrality, the review found depressed mood most often ranked as a top central node in networks restricted to DSM-defined symptoms. However, when comorbidities and wider symptom sets were included, depressed mood’s presence among top central nodes fell from 80.6% to 59%, while anxiety symptoms—uncontrollable worry, trouble relaxing, and nervousness—moved toward the center.