Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul:139:185-192.
doi: 10.1016/j.jpsychires.2021.05.013. Epub 2021 May 7.

Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem

Sophia Miryam Schüssler-Fiorenza Rose  1 , Nicholas T Bott  2 , Erin E Heinemeyer  3 , Nathan C Hantke  4 , Christine E Gould  5 , Rayna B Hirst  6 , Joshua T Jordan  7 , Sherry A Beaudreau  8 , Ruth O'Hara  8
Affiliations

Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem

Sophia Miryam Schüssler-Fiorenza Rose et al. J Psychiatr Res. 2021 Jul.

Abstract

Objective: To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions.

Methods: We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count.

Results: There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years.

Conclusions: Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.

Keywords: Age; Behavioral risk factor surveillance system (BRFSS); Cognitive symptoms; Comorbid health conditions; Depression; Functional impact.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

Dr. Bott discloses a commercial interest in Neurotrack. Dr. Gould received research support from Meru Health, Inc, for an investigator-initiated trial. All other authors report no financial relationships with commercial interests.

Figures

Figure 1
Figure 1. Cognitive Symptoms and Depression by Other Health Condition Count
The x-axis shows the number of other health conditions and weighted percentage of participants having that health condition count. The percentage of participants reporting cognitive symptoms (worsening confusion or memory loss in the past 12 months) is shown in red. The percentage of participants reporting a depression history (ever being told by a healthcare provider that they had a depressive disorder) is shown in blue.
Figure 2
Figure 2. Adjusted Odds of Cognitive Symptoms by Age Group and Depression History
Figure 2a shows the adjusted odds of participants reporting cognitive symptoms (worsening confusion or memory loss in the past 12 months) by age group and depression history using the oldest age group (75 years and older) as the reference and adjusting for demographic characteristics (age, sex, race, education). Figure 2b shows the odds of cognitive symptoms by age group and depression history adjusting for demographics and other health condition count with the oldest age group as the reference. Both models included an age group by depression history interaction term. Abbreviations: OR, odds ration; CI, Confidence interval
Figure 3
Figure 3. Adjusted Odds of Functional Impact and Professional Advice Seeking due to Cognitive Symptoms by Age group
Figure 3 shows the adjusted odds of reporting a functional impact of cognitive symptoms by age group (reference is oldest age group (75 plus years)) and depression history (reference is no history of depression). Each impact was modeled separately and adjusted for demographic characteristics (age, sex, race, education) and number of other health conditions. Abbreviations: OR, odds ration; CI, Confidence interval
See this image and copyright information in PMC

References

    1. American Psychiatric Association, 2013. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Pub.
    1. Arve S, Tilvis RS, Lehtonen A, Valvanne J, Sairanen S, 1999. Coexistence of lowered mood and cognitive impairment of elderly people in five birth cohorts. Aging 11, 90–95. - PubMed
    1. Brailean A, Steptoe A, Batty GD, Zaninotto P, Llewellyn DJ, 2019. Are subjective memory complaints indicative of objective cognitive decline or depressive symptoms? Findings from the English Longitudinal Study of Ageing. J. Psychiatr. Res. 110, 143–151. - PubMed
    1. Case A, Deaton A, 2015. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc. Natl. Acad. Sci. U. S. A. 112, 15078–15083. - PMC - PubMed
    1. Centers for Disease Control and Prevention, 2013. Behavioral Risk Factor Surveillance System 2011 Summary Data Quality Report [WWW Document]. URL http://www.cdc.gov/brfss/annual_data/2011/pdf/2011_summary_data_quality_... (accessed 8.3.15).

Publication types