A Cross-sectional Case-control Study on Metacognition, Neurocognitive Functions, and Quality of Life Among Older Adults with Depressive Disorder

Background: Geriatric depression is a prevalent mental health concern that impairs daily functioning, quality of life (QoL), and cognitive performance. Maladaptive metacognitive beliefs and executive dysfunction are hypothesized to contribute to depressive symptomatology in older adults. Methods: Participants were assessed using the Metacognitions Questionnaire-30 (MCQ-30), the Indian Council of Medical Research Neurocognitive Toolbox (verbal episodic memory, verbal fluency, and set-shifting), and World Health Organization Quality of Life–BREF (WHOQOL-BREF). Depression severity and suicidality were measured using the Geriatric Depression Scale-15 (GDS-15) and the Columbia-Suicide Severity Rating Scale (C-SSRS), respectively. Group differences were analyzed using Mann–Whitney U tests, associations using Spearman’s rho, and predictors using binary logistic regression (95% confidence interval). Results: Compared to controls, older adults with depression showed higher negative beliefs about uncontrollability and danger, which significantly predicted depression (OR = 1.81, p < .01), while need to control thoughts was protective (OR = 0.48, p < .01). The depression group demonstrated poorer verbal episodic memory, verbal fluency, and set-shifting ( p < .05–.01). Depression severity was positively correlated with suicidality ( r = 0.68) and negatively with QoL ( r = −0.54; p < .001). Conclusion: Maladaptive metacognitive beliefs and executive dysfunction are associated with geriatric depression. Interventions integrating metacognitive therapy (MCT) with cognitive flexibility and verbal fluency training may improve emotional well-being, functional independence, and QoL in older adults.