Temporal dynamics of perceived self-reliance and psychiatric symptoms in older adults: applying dynamic time warping to longitudinal cohort data

Objectives: Contemporary public health and care policies expect that promoting self-reliance can help older adults prevent or recover from morbidity, including psychiatric disorders. We sought to clarify the role of self-reliance dynamics in developing and recovering from psychiatric symptoms throughout the aging process. Method: We used dynamic time warping to analyze the temporal ordering of within-person changes in five self-reliance indicators (three self-efficacy dimensions, mastery, self-esteem) and psychiatric symptoms in N = 1968 participants aged 55+ in the Longitudinal Aging Study Amsterdam, measured up to ten times across up to 30 years. Participants were categorized as symptomatic or asymptomatic based on reporting clinically relevant depressive and/or anxiety symptoms. Results: At baseline, mean age was 63.7 years and 54.2% of participants were female. In the symptomatic group, changes in symptoms generally preceded changes in self-reliance. The reverse was observed in the asymptomatic group. Among participants with anxiety, changes in mastery preceded changes in symptoms. Conclusion: Within-person changes in self-reliance may have limited value as early warning signs for declining mental health, although in older adults who develop anxiety, declining mastery may signal worsening symptoms. Findings underscore the complex interplay of self-reliance and psychiatric symptoms and highlight the complementary value of dynamic time warping analyses.