Semester of Graduation

Spring 2025

Degree

Master of Arts (MA)

Department

Psychology

Document Type

Thesis

Abstract

The capacity to complete instrumental activities of daily living (IADL) is essential to older adults maintaining their ability to age in place and is influenced by factors including depression and cognition. There is evidence to suggest that depression and cognition influence each other in their relationship with everyday functioning. However, much of this work has been done in samples with low overall levels of depressive symptoms. The goal of the current study was to examine these relationships in older adults with a history of moderate to severe treatment resistant depression and determine if the relationship between executive functioning and everyday functioning is driven by speed of processing. A sample of 230 older adults enrolled in the Optimum Neuro study were used. Participants completed a neuropsychological assessment battery, depression questionnaires, and a performance-based measure of everyday functioning. Simple linear regressions were used to determine if depression scores predicted individual domains of cognition and everyday functioning. Cognitive domain scores predicted by depression were then tested as mediators between depression and everyday functioning. Secondary analyses calculating residualized difference scores to factor out speed from performance on measures of executive functioning were used to determine if everyday functioning was driven more by speed or by pure executive functioning. Depression was correlated with everyday functioning and immediate memory but not any other cognitive domain scores. Immediate memory partially mediated the relationship between depression and everyday functioning. Both the pure executive functioning model and the model with speed of processing still included were significantly predictive of everyday functioning. The relationship between depression and everyday functioning was partially mediated by immediate memory, suggesting immediate memory may be an important intervention target for preserving independence. There may also be additional non-cognitive factors influencing this relationship. The relationship between executive functioning and everyday functioning continues to predict everyday functioning even after removing variance associated with processing speed.

Date

3-17-2025

Committee Chair

Calamia, Matthew

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