Severity of Cognitive Impairment and Its Correlation With Depressive Symptoms and Influencing Factors in Elderly Patients With Chronic Diseases.

Abstract

Background: Elderly individuals frequently suffer from chronic underlying disease like hypertension and diabetes. These illnesses not only impair physical health but also show a close link to elevated rates of cognitive impairment and depressive symptoms. The mutual influence between these two issues can further diminish the quality of life of elderly patients. Nevertheless, there remains a shortage of systematic investigations into the cognitiveemotional relationship within this specific population.

Methods: A total of 206 elderly patients with chronic underlying disease were enrolled retrospectively. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Depressive symptoms were evaluated via the 15-item Geriatric Depression Scale (GDS-15). To analyse the correlation between cognitive impairment and depressive symptoms, the Spearman correlation analysis, univariate analysis, and multivariate Logistic regression were employed.

Results: Among the 206 patients, the primary chronic underlying diseases were hypertension (64.56%), diabetes mellitus (39.32%), coronary heart disease (27.67%), and chronic obstructive pulmonary disease (21.84%). Additionally, 45.15% of the patients had two or more chronic diseases. The prevalence of cognitive impairment stood at 49.51% (102 cases), while the prevalence of depressive symptoms was 40.78% (84 cases). No significant differences were observed in the prevalence of cognitive impairment and depressive symptoms among patients with different types of chronic diseases (all p > 0.05). Spearman correlation analysis revealed a significant negative correlation between MoCA scores and GDS-15 scores (r = -0.552, p < 0.001). Binary Logistic regression analysis indicated that factors such as body mass index ≥21.42 kg/m² , number of chronic diseases ≥2.5, GDS-15 score ≥4.5 points, and Multidimensional Scale of Perceived Social Support score ≥52.5 were independent risk factorsfor moderate-to-severe cognitive impairment (all p < 0.05).  Conclusions: The severity of cognitive impairment in elderly patients with comorbid chronic underlying diseases increases with the exacerbation of depressive symptoms.