From dysphoria to anhedonia: Age-related shift in the link between cognitive and affective symptoms

Aging affects cognition, emotion, and brain structure, yet how these domains interact remains unclear. We examined cognitive-affective symptom networks in 756 young (≤45 years) and 1,230 older (≥65 years) adults. Cognition was assessed with the Addenbrooke’s Cognitive Examination Revised, and affective symptoms were assessed with the Hospital Anxiety and Depression Scale. Graphical LASSO estimated network structure, computing strength centrality for overall network structure and two independent bridging centrality measures for measuring cognitive-affective links. While overall network structure was similar across age groups, depressive (not anxiety) symptoms were more strongly linked to cognition in older adults. The key bridging symptom shifted from dysphoria in young adults to anhedonia in older adults. Anhedonia was also associated with the relationship between gray matter volume and cognition, particularly in older adults. The results suggest an age-related shift in how cognitive and affective symptoms interact across the lifespan, highlighting the need for age-specific interventions.