Depression, anxiety and cognitive performance in community-dwelling older adults: A measurement-based approach

Abstract

• Depression and anxiety are highly prevalent among community-dwelling older adults in Ghana. • Measurement-based CFA confirmed robust latent constructs of mood and cognition. • Depression showed the strongest negative effects on memory and executive function. • Anxiety was more strongly associated with attentional deficits than other domains. • Combined mood disturbances explained substantial variance in late-life cognitive decline. Depression and anxiety are common among older adults and are associated with cognitive functioning. This study examined their prevalence and relationships with cognitive domains among community-dwelling older adults in Ghana. A cross-sectional study of 350 participants aged 60 years and above was conducted. Depression and anxiety were assessed using the GDS-15 and GAI, and cognitive performance was evaluated across memory, attention, executive function, and processing speed. Confirmatory factor analysis (CFA) validated latent constructs, and structural equation modeling (SEM) examined relationships between mood disturbances and cognition. Clinically significant depressive and anxious symptoms were observed in 28% and 32% of participants, respectively. Depression most strongly correlated memory (β = -0.34) and executive function (β = -0.31), while anxiety most strongly correlated attention (β = -0.25). Combined effects of depression and anxiety explained 19-29% of variance across cognitive domains. Depression and anxiety are prevalent and co-occurring in older Ghanaian adults, contributing to domain-specific cognitive decline. Targeted interventions may help preserve memory, executive function, and attention.