Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care

Alex D Federman; Jacqueline Becker; Fernando Carnavali; Monica Rivera Mindt; Dayeon Cho; Gaurav Pandey; Lili Chan; Laura Curtis; Michael S Wolf; Juan P Wisnivesky

doi:10.1177/23337214231214217

Relationship Between Cognitive Impairment and Depression Among Middle Aged and Older Adults in Primary Care

Gerontol Geriatr Med. 2024 Mar 11:10:23337214231214217. doi: 10.1177/23337214231214217. eCollection 2024 Jan-Dec.

Authors

Affiliations

¹ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
² Fordham University, New York, NY, USA.
³ Northwestern University, New York, NY, USA.

Abstract

Objectives: To determine rates of previously undetected cognitive impairment among patients with depression in primary care. Methods: Patients ages 55 and older with no documented history of dementia or mild cognitive impairment were recruited from primary care practices in New York City, NY and Chicago, IL (n = 855). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and depression with the Patient Health Questionnaire-8. Results: The mean age was 66.8 (8.0) years, 45.3% were male, 32.7% Black, and 29.2% Latinx. Cognitive impairment increased with severity of depression: 22.9% in persons with mild depression, 27.4% in moderate depression and 41.8% in severe depression (p = .0002). Severe depression was significantly associated with cognitive impairment in multivariable analysis (standardized β = -.11, SE = 0.33, p < .0001). Discussion: Depression was strongly associated with previously undetected cognitive impairment. Primary care clinicians should consider screening, or expand their screening, for both conditions.

Keywords: Montreal Cognitive Assessment; cognition; mental health.