Abstract
Background
Cognitive impairment has become a major public health issue. Depressive symptoms and cognitive impairment are closely related disorders in the aging population. However, the effect of proactive health on the association between depressive symptoms and cognitive impairment was not clear. This study aimed to examine the mediating role of proactive health in the effect of depressive symptoms on cognitive impairment.
Methods
This population-based cross-sectional study recruited 3607 participants aged 60 and above from the China Health and Retirement Longitudinal Study. Direct relationships between depressive symptoms, proactive health, and cognitive impairment were analyzed using multiple logistic regression. The bootstrap method was used to test the mediating role of proactive health in the effect of depressive symptoms on cognitive impairment.
Results
After adjusting the confounders, participants in the depressive symptoms group (OR 1.223, 95% CI, 1.047-1.429) and depression group (OR 1.892, 95% CI, 1.401-2.554) had an increased risk of cognitive impairment, while those who had fair proactive health literacy (OR 0.668, 95% CI, 0.499-0.895) and good proactive health literacy (OR 0.498, 95% CI, 0.358-0.694) had a decreased risk of cognitive impairment.
The mediation effect of proactive health accounted for 6.47 % of the total effect regarding depressive symptoms with cognitive impairment.
Conclusions
This study revealed that depressive symptoms not only directly influenced cognitive impairment among older adults but also indirectly via proactive health. Exercise should be encouraged among the elderly to promote their participation in social activities, thereby improving their proactive health literacy and ultimately preventing cognitive impairment.