Association between depression and cognitive function in adults aged 50 years and older: A cross-sectional study of NHANES 2011-2014.

Authors

Xu Chen, Mingjie Cao, Huiying Chen

Published in

Medicine. Volume 105. Issue 46. Pages e51213. Nov 13, 2026.

Abstract

Cognitive impairment and depression frequently coexist in older adults. This study examined their association among adults aged ≥50 years using nationally representative National Health and Nutrition Examination Survey (NHANES) data. This cross-sectional study analyzed NHANES 2011 to 2014 data from adults aged ≥50 years. Depression was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥10, and cognitive function was assessed using the Consortium to Establish a Registry for Alzheimer's Disease Word Learning, Animal Fluency Test, and Digit Symbol Substitution Test (DSST). Weighted multivariable linear regression models accounting for the NHANES complex sampling design were used to examine the association between depression status and standardized cognitive performance. Cognitive test scores were converted to Z-scores before regression analysis. Among 2729 participants, 671 had depression (weighted prevalence, 24.59%). Participants with depression performed significantly worse across all cognitive assessments (all P < .01). In fully adjusted models, depression was significantly associated with lower standardized cognitive performance across all domains, including delayed word recall (β = -0.089, 95% confidence interval [CI]: -0.145--0.034, P = .003), total word recall (β = -0.033, 95% CI: -0.055--0.010, P=.006), Animal Fluency Test performance (β = -0.044, 95% CI: -0.066- - 0.021, P < .001), and Digit Symbol Substitution Test performance (β = -0.031, 95% CI: -0.042--0.019, P < .001). Depression status was associated with poorer cognitive performance across multiple domains in adults aged ≥50 years. Longitudinal studies are needed to clarify the temporal relationship between depression and cognitive decline.

PMID:
43024304
Bibliographic data and abstract were imported from PubMed on 14 Nov 2026.

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