A Study on the Association Between Social Activity and Depression and Cognitive Function in Patients with Heart Disease: The Mediating Role of Activities of Daily Living.

BACKGROUND: Patients with heart disease are frequently accompanied by heightened depressive symptoms and cognitive decline. Social activity (SA) and activities of daily living (ADL) may affect these associations. This study aims to investigate the associations between depression, cognitive function, and SA in patients with heart disease, and further assess the mediating role of ADL. METHODS: Multivariate linear and logistic regression models were adopted to assess the correlations between SA scores (SAs), depression, and cognitive function. Restricted cubic spline (RCS) regression was employed to detect potential non-linear relationships. Subgroup and interaction analyses were conducted to identify heterogeneous associations across population subgroups, while mediation analysis was performed to assess indirect pathways through ADL. RESULTS: Higher SAs were significantly correlated with lower odds of depression (OR = 0.90, 95% CI: 0.86-0.94, P < .001) and higher cognitive scores (β = 0.15, 95% CI: 0.09-0.22, P < .001) with evident dose-response trends. RCS results showed no significant non-linear associations between SAs and depression or cognitive function (P-non-linear > .05). Subgroup analysis showed that the association between SAs and cognitive function was modified by urban-rural disparities (P for interaction = .028). Exploratory mediation analysis showed that ADL could account for 28.5% and 20.3% of the total effect of SA on depression and cognitive function, respectively. CONCLUSION: Higher SA engagement was associated with lower odds of depression and better cognitive function in patients with heart disease. Cardiac rehabilitation strategies should encourage active participation in SA while emphasizing recovery of daily functioning.