The association of spousal depressive symptoms and cognitive function among older adults: mediation and moderated mediation analyses

Abstract

Objectives

To test whether contagious depressive symptoms mediate the association between spousal depressive symptoms (spousal-DS) and the other spouse’s cognitive function, and test the moderated mediation of social activities engagement and sleep quality.

Study design

A total of 3,230 adults aged ≥60 and one of his/her close relatives were interviewed in 2016 in Xiamen, China.

Methods

Cognitive function and depressive symptoms were measured by MoCA and GDS-15/CES-D-10, respectively. Social activities engagement and sleep quality were self-reported. Mediation and moderated mediation were tested by PROCESS macro with 5000 bootstrapping re-samples.

Result

Among all, 1,193 pairs were husband-wife with complete information and were included. The mean ages of older adults and their spouses were 68.35 ± 6.53 and 66.53 ± 7.91 years, respectively. The mean MoCA and GDS-15 scores for older adults were 22.21 ± 5.45 and 1.73 ± 2.17, respectively. The average score of CES-D-10 for spouses was 14.18 ± 4.77. Spousal-DS were associated with cognitive functions of older adults via the contagious depressive symptoms (indirect effect: −0.048, 95% confidence interval (CI): (-0.075, −0.028)). Such mediation can be buffered by attending social activities (interaction: −0.062, 95% CI: (-0.111, −0.013)) and improving sleep quality (interaction: −0.034, 95% CI: (-0.057, −0.012)).

Conclusion

Cognitive function of older adults was associated with his/her spouse’s depressive symptoms, and the association was mediated by contagious depressive symptoms and moderated by social activities as well as sleep quality.

Keywords:

• spousal depressive symptoms
• cognitive function
• social activities
• sleep quality

Acknowledgments

We really appreciate the Xiamen Municipal Committee on Aging for supporting this study and the efforts the staff and volunteers made by working on ageing in these communities. We are also grateful to the students from the School of Public Health, Xiamen University, who participated in the data entry and checking of returned surveys.

Authors’ contributions

Investigation: MY, RT, YH; Methodology: MY, RT, MR, YH; Project administration: MY, YH, YF; Writing: MY, RT, MR; Writing-review & editing: MY, RT, MR, YF.

Ethics approval

Ethical review of this study was approved by the Committee of the School of Public Health, Xiamen University (SPH-XMU2015006).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (grant number 81973144) and Natural Science Foundation of Xiamen, China (Grant number: 3502Z20227014).