Imagine you’re driving an older car (the NHANES 2011-2014 cycle) and suddenly you hear a weird noise coming from the engine. You’re worried about what could be wrong, so you take it to the mechanic (the present study). Turns out, there are two issues: depression and cognitive impairment. These two problems are like a double whammy for your car (older adults), causing functional disability and increasing the risk of a breakdown (mortality). The mechanic investigates further and discovers that not only do depression and cognitive impairment individually affect your car’s functioning, but when they team up, they have an even greater impact on different aspects of your car’s performance (disability in activities of daily living, cardiovascular health, etc.). It’s like having a worn-out transmission and a faulty fuel pump at the same time – it’s a recipe for disaster. And guess what? The more severe these issues are, the higher the risk of your car giving out completely (all-cause mortality). Even after accounting for other potential problems (adjusting for different levels of disability), the combination of depression and cognitive impairment still tops the charts for its detrimental effects. So, if you want to keep your car running smoothly (and extend its lifespan), taking care of both depression and cognitive function is crucial. To learn more about this study’s findings and dive deeper into the research behind it, check out the full article!

ObjectiveThe present study aimed to explore the combined associations of depression and cognitive impairment with functional disability and mortality, and whether the joint effects of depression and cognitive impairment on mortality were influenced by functional disability.MethodsA total of 2,345 participants aged 60 and above from the 2011–2014 cycle of the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Questionnaires were used to evaluated depression, global cognitive function and functional disability (including disability in activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA)). Mortality status was ascertained up to December 31, 2019. Multivariable logistic regression was performed to investigate the associations of depression and low global cognition with functional disability. Cox proportional hazards regression models were conducted to evaluate the effect of depression and low global cognition on mortality.ResultsInteractions between depression and low global cognition were observed when exploring associations of depression and low global cognition with IADLs disability, LEM disability, and cardiovascular mortality. Compared with normal participants, participants with both depression and low global cognition had the highest odds ratios of disability in ADLs, IADLs, LSA, LEM, and GPA. Besides, participants with both depression and low global cognition also had the highest hazard ratios of all-cause mortality and cardiovascular mortality, and these associations remained after adjusting for disability in ADLs, IADLs, LSA, LEM, and GPA.ConclusionOlder adults with both depression and low global cognition were more likely to have functional disability, and had the highest risk of all-cause mortality and cardiovascular mortality.

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