Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life

Abstract

Background: The association between depression and functional disability in late life remains unclear. This study aimed to explore the relationship between depressive symptoms and daily functioning through the mediation of cognitive abilities, measured by memory, reasoning, and speed of processing.

Methods: The authors recruited 2,832 older adults (mean age = 73.6 years, standard deviation = 5.9) participating in the Advanced Cognitive Training for Independent and Vital Elderly Study. Structural equation modeling was applied to illustrate the relationship between depressive symptoms and everyday problem-solving ability through the mediation of cognitive abilities.

Results: Depressive symptoms were associated with impaired everyday problem-solving ability directly and indirectly mediated through learning and memory, and reasoning. Although depressive symptoms were associated with speed of processing, speed of processing was not significantly related to everyday problem-solving ability.

Conclusions: This study conceptualizes the possible relationships between depressive symptoms and daily functioning with mediation of cognitive abilities and provides a feasible model for the prevention of functional impairment related to geriatric depressive symptoms.

Figures

Figure 1

Hypothesized models guiding the analysis of the relationships of depressive symptoms, memory, reasoning, speed of processing, and functioning.

Figure 2

Structural equation model relating depression scores to performance measures of function through measures of memory, reasoning, and speed of processing. Note: Standardized parameter estimates are provided. Covariates (i.e., gender, age, race, education, and health conditions) were included in the analysis but not shown here. X2 test (df=1) was applied for the significance of each coefficient in the selected model. (CES-D, Center for Epidemiologic Studies Depression Scale; *p<0.05; **p<0.01; ***p<0.001)