Gerontology and Geriatric Medicine (Jan 2024)

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

  • Alex D. Federman MD, MPH,
  • Jacqueline Becker PhD,
  • Fernando Carnavali MD,
  • Monica Rivera Mindt PhD,
  • Dayeon Cho MPH,
  • Gaurav Pandey PhD,
  • Lili Chan MD,
  • Laura Curtis PhD,
  • Michael S. Wolf PhD,
  • Juan P. Wisnivesky MD, DrPH

DOI
https://doi.org/10.1177/23337214231214217
Journal volume & issue
Vol. 10

Abstract

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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.