Key result
Depressive symptoms and antidepressant use linked to ~5-point lower self-reported physical function score.
Why the study?
Depressive symptoms are linked to lower physical function in middle-aged adults, but studies have overlooked the role of antidepressant medications.
Do elevated depressive symptoms and antidepressant medication use reduce physical function in middle-aged adults?
Cross-Sectional (n=2,021)
Yes
Do elevated depressive symptoms and antidepressant medication use reduce physical function in middle-aged adults?
Elevated depressive symptoms and antidepressant medication use, either alone or in combination, are associated with significantly lower physical performance and self-reported physical function in middle-aged adults.
Should not yet change practice; extends prior associations in middle-aged adults but remains hypothesis-generating.
Depressive symptoms (DS) are associated with lower physical function among older adults, and similar associations have been shown in middle-aged adults. However, studies have overlooked the role of antidepressant medications. We conducted a cross-sectional analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) Function study. Analysis included measured physical performance and self-reported function. Elevated DS were defined by the Center of Epidemiological Studies Depression (CESD) as ≥16. Participants were grouped by level of DS (DS-: <16, DS+: ≥16) and antidepressant use (med-: none, med+: any) into one of four categories: DS−/med-, DS−/med+, DS+/med-, and DS+/med+. Multiple linear regression was used to examine associations between DS and antidepressant use with physical function in middle age. Participants ( n = 2021; 60 ± 4 years, 58.1% female, 44.4% Black race) were categorized to the DS/medication groups as follows: DS-/med-: 73.8%, DS-/med+: 8.3%, DS+/med-: 11.9%, and DS+/med+: 6.0%. Both physical performance and self-reported function scores were highest in the DS-/med- group. Compared to the DS-/med- group (reference), regression coefficients in the fully adjusted model for performance score were -0.73, -0.94, and -0.47 in the DS-/med+, DS+/med-, and DS+/med+ groups, respectively (all p < 0.01, except the DS+/med + group). Compared to the DS−/med- group, regression coefficients in the fully adjusted model for self-reported function score were -1.95, -3.86, and -4.91 in the DS-/med+, DS+/med-, and DS+/med+ groups, respectively (all p < 0.01). Compared to individuals with low/no DS and no antidepressant medication use all other groups had lower physical performance and self-reported physical function. • Middle-aged adults with low/no depression and no antidepressant use had the highest physical function. • Elevated depression and antidepressant use, either singly or in combination, was associated with reduced physical function. • Middle-aged adults taking antidepressants but still experiencing elevated depression had the lowest physical function. What this adds to what is known? • At-risk patients may benefit from a multidisciplinary treatment approach that considers both depression and function. What is the implication and should change now? • Future research should examine the longitudinal relationship between depression, antidepressant, and physical function as adults transition from middle age to older age.
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Burrows et al. (2026) conducted a cross-sectional in Depressive symptoms and functional decline (n=2,021). Elevated depressive symptoms and antidepressant use vs. Low/no depressive symptoms and no antidepressant use was evaluated on Self-reported physical function (PROMIS-SF20a score) (MD -4.91, p=<0.01). Elevated depressive symptoms and antidepressant use were associated with a 4.91-point reduction in fully-adjusted self-reported physical function score compared to no depression and no medication.
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