From dysphoria to anhedonia: Age-related shift in the link between cognitive and affective symptoms
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Background
Depression in aging shows heterogeneous symptoms across cognitive, affective, and neurobiological domains. Traditional categorical diagnoses may not capture these complex patterns, prompting a shift toward dimensional or domain-based approaches. We examined whether the symptoms that bridge cognition and affect differ by age, and explored their associations with brain structure.
Methods
Data from 756 young (≤45 years) and 1230 older (≥65 years) adults from the Cambridge Centre for Ageing and Neuroscience were analysed. Cognition was assessed using the Addenbrooke’s Cognitive Examination Revised, and depressive and anxiety symptoms with the Hospital Anxiety and Depression Scale. Graphical LASSO was used to construct cognitive-affective networks, testing for age-related differences in strength and bridging centrality measures. Building on these findings, we further examined the association between bridging symptoms, cognition, and gray matter volume (GMV).
Results
Symptom strength centrality was similar across groups. However, in older but not in younger adults, depressive symptoms were more strongly connected to cognitive symptoms than anxiety symptoms. The primary bridging symptom shifted with age, from dysphoria in young adults to anhedonia in older adults. Follow-up analyses indicated that the anhedonia-to-dysphoria difference was associated with the relationship between GMV and cognition, particularly in older adults.
Conclusions
Cognitive-affective bridging symptoms differ with age, with anhedonia replacing dysphoria as the key bridge in older adults. This shift was linked to differences in how GMV relates to cognition in late life. These results highlight the need to target different symptoms to alleviate cognitive-affective manifestations across the lifespan.
