Cardiorespiratory Fitness Mediates the Relationship between Depressive Symptomatology and Cognition in Older but not Younger Adults

Barros, Catarina; Sampaio, Adriana; Pinal, Diego · 2023 · Crossref

DOI: 10.21203/rs.3.rs-3711433/v1

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Summary

This study investigates the interplay between depressive symptomatology, cardiorespiratory fitness (CRF), and cognitive performance in young adults (YA) and older adults (OA). Motivated by evidence that depression is a risk factor for cognitive decline and that physical activity may offer protection, the researchers aimed to determine if CRF mediates the relationship between depressive symptoms and cognition across these two life stages. The study specifically tested whether the adverse effects of depression on cognition are driven by decreased CRF, hypothesizing that this mediation would occur in both age groups. The study included 81 OA (aged 60–89) and 77 YA (aged 18–34) who underwent sociodemographic interviews, emotional assessments, cognitive testing, and physical evaluations. Emotional status was measured using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI-Y). Cognitive function was assessed via the Mini-Mental State Examination (MMSE) for general cognition and the Cambridge Neuropsychological Test Automated Battery (CANTAB) for short-term memory (Spatial Span) and executive functions, specifically inhibitory control and cognitive flexibility (Multitasking). CRF was estimated using a validated equation incorporating sex, age, BMI, resting heart rate, and self-reported physical activity from the International Physical Activity Questionnaire. Statistical analyses included t-tests, Mann-Whitney tests, linear regressions, and mediation models using the PROCESS macro. Results indicated that OA exhibited significantly lower performance in general cognition, inhibitory control, cognitive flexibility, memory, and CRF compared to YA, along with higher visceral fat and BMI. However, there were no significant differences in depressive symptoms or anxiety between the groups. Regression analyses revealed that depressive symptomatology predicted CRF in both age groups but predicted cognitive performance only in OA. Conversely, CRF predicted cognitive outcomes only in OA. Mediation analyses demonstrated that CRF fully mediated the relationship between depressive symptomatology and general cognition in OA, meaning the negative impact of depression on general cognition was entirely explained by lower CRF. CRF also partially mediated the relationship between depressive symptoms and memory in OA. No mediation effects were found for YA or for executive functions in OA, although an interaction suggested CRF might moderate the effect of depression on cognitive flexibility. The findings suggest that while depressive symptoms reduce physical fitness across the lifespan, their detrimental impact on cognition is specific to older adults and is driven by reduced cardiorespiratory fitness. This supports the cardiorespiratory hypothesis, indicating that the physiological benefits of an active lifestyle protect against the cognitive consequences of depression in aging. The study highlights CRF as a pivotal protective factor, implying that interventions promoting physical activity and managing depressive symptoms could help mitigate age-related cognitive decline. The results underscore the need for age-specific health strategies, as the mechanisms linking emotional, physical, and cognitive well-being differ significantly between young and older adults.

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• cognitive impairment