ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Depressive symptoms in hospitalized geriatric patients with and without cognitive impairment: a cross-sectional network analysis approach
Provisionally accepted
- 1Universitatsklinikum Halle Saale, Halle (Saale), Germany
- 2University Hospital Jena, Jena, Germany
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Background: Late-life depression is common and often co-occurs with cognitive impairment, complicating its assessment and clinical management. Network analysis allows for a nuanced understanding of how individual depressive symptoms interact. This study examines differences in the network structure of depressive symptoms in geriatric patients with and without cognitive impairment. Methods: We included monocentric cross-sectional data of 3,990 hospitalized geriatric inpatients whose depressive symptoms were rated using the 15-item Geriatric Depression Scale (GDS). Patients were stratified into an unimpaired and impaired cognition group depending on the Mini-Mental State Examination (MMSE) (cut-off < 24 points). Network analyses were estimated separately for both groups using regularized logistic regression models. A network comparison test was conducted for group comparison. Results: Our study showed that worthlessness was the most central depressive symptom. However, the network structures differed notably between the two groups, with less impact of feeling empty when cognitive impairment is present, as well as a stronger association between feeling unsatisfied and unhappy, and a weaker connection between feeling empty and bored. Conclusion: These differences highlight the need for clinicians and public health professionals to adapt their screening and intervention strategies to take into account the subtle presentation of depressive symptoms in older adults according to cognitive status.
Keywords: cognitive impairment, Depression, geriatric assessments, oldest-old, Symptom network
Received: 20 Aug 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Prell, Schönenberg and Heimrich. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Konstantin G Heimrich
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