Dynamic Network Analysis of Multidimensional Symptoms in Older Patients with Chronic Gastritis

Objective : Based on the biopsychosocial model and the Comprehensive Geriatric Assessment framework, this study applied dynamic network analysis to investigate the evolving interrelations among physical and psychological symptom clusters in older patients with chronic gastritis. Methods : A longitudinal design with convenience sampling was used to recruit 360 hospitalized chronic gastritis patients aged ≥ 60 years. Assessments were conducted at admission (T1) and 6 months post-discharge (T2). Data were collected using a general information questionnaire, the Comprehensive Geriatric Assessment, and the Gastrointestinal Symptom Rating Scale. Symptom networks were constructed using R, and centrality indices were calculated to identify core symptoms and structural changes. Results : At T1, anxiety, depression, and cognitive function were the core nodes of the network. At T2, frailty, social participation, and fall risk became dominant. Centrality of gastrointestinal symptoms (abdominal pain, diarrhea, constipation) and activities of daily living (Barthel Index) significantly decreased at T2 (C = −0.176 to −0.824, P < 0.05), whereas psychosocial factors (anxiety, depression, well-being) remained stable ( P > 0.05). Global network strength increased from 4.75 (T1) to 5.95 (T2) ( P < 0.001). Conclusion : The network core shifted from psychological-cognitive factors at admission to physical-functional indicators at follow-up, revealing a dynamic psychosomatic interaction pattern centered on psychosocial factors.