Daily Living, Depressive Symptoms, and Cognition in Older Adults With Chronic Diseases

This study examined the associations of activities of daily living (ADL) limitations and depressive symptoms with global and domain-specific cognition among older adults with chronic diseases. Data were drawn from the 2020 wave of the China Health and Retirement Longitudinal Study, including 5,112 participants aged ≥60 years. Functional ability and depressive symptoms were assessed using the ADL scale and CES-D-10, respectively. Cognitive function was assessed using CHARLS cognitive measures, including the Telephone Interview of Cognitive Status-10 and other cognition-related items. Spearman correlation and path analyses were performed using AMOS and Stata. ADL limitations were associated with poorer global and domain-specific cognitive function, and depressive symptoms accounted for part of these associations in the path models. The proportion accounted for by the indirect effect ranged from 17.39% for visuospatial ability to 60.27% for delayed recall. These findings suggest that functional status, depressive symptoms, and cognition are closely interrelated in this population.