Alpha Psychiatry. 2025 Aug 31;26(5):39349. doi: 10.31083/AP39349. eCollection 2025 Oct.
ABSTRACT
OBJECTIVE: This study examined the relationships between socioeconomic status (SES), depression, and cognitive function in older adults, with a focus on the mediating or moderating role of depression in the link between SES and cognitive function.
METHODS: Data were analyzed from 5527 participants in the Anhui Healthy Longevity Survey (AHLS). SES was determined by educational attainment and individual annual income; depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9); and cognitive function was evaluated with the Mini-Mental State Examination (MMSE). Linear regression analyses were conducted to investigate the relationships among SES, depressive symptoms, and cognitive function. The PROCESS macro in SPSS was utilized to perform both mediation and moderation analyses, following established procedures.
RESULTS: Compared to low SES, both medium SES (B = 4.115, p < 0.001) and high SES (B = 6.827, p < 0.001) were both positively associated with MMSE scores and negatively associated with PHQ-9 scores (B = -0.827, p < 0.001; and B = -1.695 -0.195, p < 0.001, respectively). Moreover, PHQ-9 scores were negatively associated with MMSE scores (B = -0.132, p < 0.001). Further analysis revealed that PHQ-9 scores partially mediated the relationship between SES and MMSE scores, with mediation effects accounting for 3.16% and 2.58% of the total effect in the high SES and medium SES groups, respectively. The absence of significant interaction between PHQ-9 scores and either high (B = 0.099, p = 0.109) or medium SES (B = 0.003, p = 0.919) suggests that depressive symptoms do not moderate the association between SES and cognitive function.
CONCLUSION: Lower SES is associated with poorer cognitive performance, with depressive symptoms partially mediating the relationship between SES and cognition.
PMID:41209508 | PMC:PMC12593830 | DOI:10.31083/AP39349
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