Poor physical functioning and depression status in young adult US Population

Context: Psychological distress in young and middle adulthood may lead to challenges in various aspects of their lives, including daily activities, social interactions, and overall quality of life.

Objective: This study aims to examine how poor physical, social, and independent functioning in a national sample of younger adults is associated with depression.

Study Design and Analysis: We conducted a secondary analysis of the 2013–2018 National Health and Nutrition Examination Survey (NHANES). We estimated surveybased Generalized linear models for depression with the Poisson family and log link function. This model allowed us to examine the adjusted prevalence ratios (aPR) for disability (total scale and subscales) after controlling for potential confounding variables.

Setting or Dataset & Population: The dataset included 1,254 community-dwelling, non-institutionalized young adults aged 18 to 40 years old.

Instruments: As part of the NHANES, participants report physical, social, and independent functioning. Gender, ethnicity, racial status, marital status, educational experience, income, physical activity, obesity, smoking, and alcohol are also surveyed.

Outcome Measures: Depression diagnosis, based on the Patient Health Questionnaire (PHQ-9), a nine-item depression screening instrument. A score of 5 and higher is considered indicative of at least mild depressive symptoms.

Results: Overall disability score of 2 and higher was independently associated with depression symptoms (aPRs: 1.74 – 2.04, maximum p=0.014) when controlled for gender, ethnicity and racial status, marital status, educational experience, income, physical activity, obesity, smoking, and alcohol. The instrumental activities of daily living (IADL; aPR: 1.21, p=0.046) and leisure and social activities (LSA; aPR: 1.79, p<0.001) subscales were also associated with depression.

Conclusion: This study demonstrates a significant association between independent functioning and symptoms of depression in younger, community-dwelling adults. The findings suggest that individuals with difficulties in daily activities are at increased risk of depression even when accounting for sociodemographic characteristics.