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Associations of depressive symptoms and antidepressant medication use with physical function among middle-aged adults: Results from the CARDIA Function study
Journal article   Open access   Peer reviewed

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

Brett T. Burrows, Richard Sloane, Marissa C. Ashner, Carl F. Pieper, Cora E. Lewis, Kelley Pettee Gabriel, Pamela J. Schreiner, Bjoern Hornikel, Kai Zhang, Nathaniel D.M. Jenkins, …
Journal of affective disorders, Vol.401, 121324
05/15/2026
DOI: 10.1016/j.jad.2026.121324
PMID: 41638502
url
https://doi.org/10.1016/j.jad.2026.121324View
Published (Version of record) Open Access

Abstract

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?•Research should study long-term link between depression, antidepressant use, and physical function from midlife to old age.
 Pharmacotherapy Cohort studies Depression Middle age Physical performance

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