Depressive symptom profiles and future cognitive and functional limitations in the health and retirement Study

Background: Depressive symptoms may differ in both severity and configuration. This study identified depressive symptom profiles in adults aged 50 years and older and examined their external correlates and prospective cognitive and functional associations.Methods: We analyzed Health and Retirement Study person-wave observations from 2006, 2010, 2014, and 2018 linked to outcomes four years later. Eight binary indicators from the Center for Epidemiologic Studies Depression Scale (CES-D) were used to estimate latent class models. External correlates were examined using corrected three-step models, and longitudinal outcomes using posterior-probability weighting and Bolck-Croon-Hagenaars (BCH) correction.Results: The sample included 68,854 person-wave observations from 28,042 individuals. A six-class solution was retained: low depressive symptoms, somatic-motivational, sadness-loneliness-sleep, somatic-affective, depressed-sadness, and generalized high depressive symptoms. All symptomatic profiles were associated with lower future cognition and greater activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations. After adjustment for total CES-D severity, global class membership remained associated with all three outcomes, with stronger evidence for functional outcomes.Conclusion: Depressive symptom configuration may provide information complementary to overall symptom burden, although the profiles should be interpreted as probabilistic descriptive patterns rather than diagnostic categories.