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Depressive Symptoms Impair Everyday Problem-Solving Ability Through Cognitive Abilities in Late Life

https://doi.org/10.1097/JGP.0b013e3181e89894Get rights and content

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.

Section snippets

Subjects

Recruitment of participants for the ACTIVE trial was conducted from March 1998 to October 1999. Details of the subject sample and the recruitment procedures have been published elsewhere.33, 34, 35 Self-reported data include age, years of education, gender, ethnicity, and the sum of reported health conditions, ranging from 0 to 8. Depressive symptoms, cognitive abilities, and everyday problem-solving ability of the participants were measured as described later. For this study, we used only the

RESULTS

Depressive symptoms, cognitive abilities, and everyday problem-solving ability for all participants are listed in Table 1. Seventy-six percent of participants were women and 72% were white, with a mean age of 73.6 years (standard deviation [SD]: 5.9) and a mean education of 13.5 years (SD: 2.7). SEM was used to operationalize the conceptual model of the mediation of cognitive process in the relationship of depressive symptoms and everyday problem-solving ability. Standardized parameter

DISCUSSION

Previous work has shown that depression affects the cognitive abilities of memory,53, 54, 55 executive reasoning,32,56, 57, 58 and speed of processing31,32,59, 60, 61 and that depression impairs daily function.62 Results of this analysis support the direct relationship of depression with both cognitive abilities and everyday problem-solving ability. The results move beyond what has been reported previously by showing that depression also affects everyday problem-solving ability through its

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    This work was supported by a series of grants awarded from the National Institute on Aging to the six field sites and the coordinating center, including the Hebrew Rehabilitation Center for the Aged (U01NR04507), the Indiana University School of Medicine (U01 NR04508), The Johns Hopkins University (U01 AG14260), the New England Research Institutes (U01 AG 14282), The Pennsylvania State University (U01 AG 14263), the University Alabama at Birmingham (R91 AG14289), and Wayne State University (U01 AG014276). Dr. Rebok is an investigator with Compact Disc Incorporated for the development of an electronic version of the ACTIVE memory intervention.

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