Associations of depressive symptoms and antidepressant medication use with physical function among middle-aged adults: Results from the CARDIA Function study

Background and objectives 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. Methods 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. Results 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). Conclusions Compared to individuals with low/no DS and no antidepressant medication use all other groups had lower physical performance and self-reported physical function.