Effect of depression combined with cognitive impairment on dependency risk in rural older adults: analysis of data from the China health and retirement longitudinal study (CHARLS 2020).

Background: This study aims to investigate the relationship between cognitive impairment, depressive symptoms, and Activities of Daily Living (ADL)/ Instrumental Activities of Daily Living (IADL) dependency among older people living in rural areas.

Methods: We analyzed data from the China Health and Aging Longitudinal Study 2020, focusing on the rural older adults over 60. We identified four groups and constructed three regression models (models 1-3) to investigate the relationship between cognitive impairment or depression and dependency.

Results: Based on a logistic regression model, older adults living in rural areas face a sequentially increased risk of dependence on ADL if they in group 2 (OR = 1.33, 95% CI = 1.09-1.63), group 3 (OR = 1.76, 95% CI = 1.43-2.17), or group 4 (OR = 2.38, 95% CI = 1.95-2.91), when compared to a reference group 1. Group 2 (OR = 2.44, 95% CI = 2.03 to 2.93) was more likely to be at risk of IADL dependence than Group 3 (OR = 1.99, 95% CI = 1.64 to 2.43).

Conclusions: This study highlights the substantial impact of depression and cognitive impairment on ADL/IADL dependence among rural older adults, with an especially heightened risk when both disorders are present simultaneously. Moreover, factors such as gender, age, inpatient services, outpatient services, and self-rated health are strongly associated with functional dependence in this population.