DEPRESSIVE SYMPTOMS ARE RELATED TO PHYSICAL AND COGNITIVE FUNCTION IN OLDER ADULTS ACROSS MULTIPLE CO-MORBIDITIES

摘要

Depressive symptoms are prevalent and may associate with physical performance and mobility, cognitive function, inflammatory biomarkers and obesity in older adults. It is not clear whether these associations are evident independent of disease or health status. Based on data of 1744 older men and women (age: 50–96 yrs) from 17 clinical studies with various co-morbidities and a set of uniform assessments, we examined associations between Center for Epidemiologic Studies Depression Scale Score (CES-D) and physical performance (Short Physical Performance Battery, grip strength, 4-meter walk, repeated chair rise, self-reported Pepper Assessment Tool for Disability, and Mobility Assessment Tool-short form), cognitive function (the Mini-Metal State Exam, the Montreal Cognitive Assessment, and the Digit Symbol Substitution Test), inflammatory biomarkers (CRP, IL-6 and TNF-alpha), and Obesity (Body Mass Index and % body fat), using multiple linear regressions adjusted for gender, age, race/ethnicity and study. The relationships were also examined within each study. The average CES-D score of all the study participants was 7.5 (range: 0–49). Higher CES-D score was negatively associated with all the physical performance tests (all p<0.05) and all the cognitive tests (all p<0.05), but not associated with the inflammatory biomarkers or obesity. More importantly, these relationships were generally independent of disease or health status such as obesity, at risk for disability, knee osteoarthritis, high cardiovascular risk profile, renal transplantation candidates or cancer. Depressive symptoms might signal physical and cognitive functional impairment in older adults across disease/health conditions, although they are often overlooked and untreated when occurring with other co-morbidities.