Cognitive status and depressive symptoms among older adults: a SEM analysis study

Abstract

The increase of age is related with high concerns of cognitive decline and depression which frequently influence each other in both directions. The objective of the current study is the assessment of the cognitive status and the symptoms indicating depression the older adults, in order to evaluate a structural model that subjective cognitive complaints mediate the relationship between objective cognitive performance and depression. The current study, cross-sectional in nature, was carried out with 140 community-dwelling senior adults (63.38 ± 7.22 years). Participants were assessed by using three standardized instruments: Abbreviated Mental Test Score (AMT) for objective cognitive performance, the Persian Cognitive Difficulties Scale (PCDS-26) for subjective cognitive complaints, and the Geriatric Depression Scale (GDS-15) for depressive symptoms. Data were analyzed by the use of SEM (Structural Equation Modeling), together with diagonally weighted least squares (DWLS) estimation to test a partial mediation hypothesis. The finalized model fit was assessed using χ²/df, CFI, TLI, and RMSEA. The structural model resulted in very impressive goodness-of-fit indices (χ²/df = 1.102, CFI = 0.996, RMSEA = 0.027). The analysis revealed that objective cognitive performance has a remarkable direct negative impact on depressive symptoms (β = -0.289, p  = 0.001). Furthermore, a significant indirect pathway was also identified (β = -0.108): higher objective cognitive performance was associated with fewer subjective cognitive complaints (β = -0.201), which in turn strongly predicted lower levels of depressive symptoms (β = 0.534). The total effect of objective cognition on depression was β = -0.397. The findings confirm that better objective cognition is linked to fewer subjective complaints and lower depression, with subjective perceptions partially mediating this relationship. This finding highlights the potential relevance of metacognitive awareness to late-life mental health. Clinically, screening for subjective cognitive complaints may help identify older adults with elevated depressive symptoms who could benefit from further assessment and appropriate interventions, such as cognitive-behavioral therapy. Therefore, clinicians should integrate assessments of subjective cognitive difficulties into routine depression screenings to provide more holistic geriatric care. Not applicable. We clarify that this research employed a cross‑sectional design, with all data gathered and analyzed at one single time point. Therefore, the study does not constitute a clinical trial.