Moderated Mediation Among Subjective Cognition, Community Participation, Depression, and Comorbidities of Middle-Aged and Older Adults

These findings suggest the importance of addressing community participation to reduce the associations between depressive symptoms and SCD among middle-aged and older adults, particularly those with more severe comorbid conditions. Plain-Language Summary: This study investigated how participation in community life influences the relationship between depressive symptoms and self-perceived decline in cognitive abilities (e.g., memory and thinking abilities) among middle-aged and older adults. We also examined whether this relationship changes based on multiple medical conditions. Ninety-three community-dwelling adults participated in this study. We used established measures to assess depressive symptoms, community participation, self-perceived cognitive decline, and multiple medical conditions. Our analysis revealed that community participation explained the link between depressive symptoms and self-perceived cognitive decline. Furthermore, the influence of community participation on this link was stronger for individuals with more severe medical conditions. These findings suggest that enhancing community participation may reduce the association between depressive symptoms and self-perceived cognitive decline, especially for those with multiple medical conditions.