Relationship between potential inappropriate medications use and cognitive frailty among older adults in the community: mediating and moderating effects of depression

Background Both cognitive frailty and potentially inappropriate medications use are relatively highly prevalent among older adults in the community, and whether depression plays a mediating and regulating role in this process remains to be further explored. Objective To examine the association between PIMs and CF among older adults in the community and to explore the mediating and regulating roles of depression. Methods From March to July 2022, a multistage sampling method was used to sample older adults in Hefei, Anhui, China. The Montreal Basic Cognitive Assessment Scale, Comprehensive Frailty Assessment Instrument, 2017 Criteria for Potentially Inappropriate Medications for Older Adults in China and Geriatric Depression Scale were used to assess 237 older adults in the community. Results The average number of PIMs taken by these participants was 2.19. PIMs and depression are important factors of CF (P < 0.01), and depression had a significant moderating effect on this factor (β = 0.107, P < 0.01). Moreover, after controlling for confounding factors, depression could regulate the relationship between PIMs and CF. Simple slope analysis revealed that the effect of PIMs on CF in individuals with low-level depression (β = 0.631, P < 0.001) was significantly greater than that in those with high-level depression (β = 0.165, P > 0.01). Specifically, when depression scores were greater than 8.550, the association between PIMs and CF disappeared. Conclusion The prevalence of CF and PIMs was greater among older adults. Depression has a synergistic effect on the occurrence of PIMs and CF. To decrease the prevalence of CF and delay the progression of dementia in this population by reducing the prevalence of PIMs, community-based health efforts should be made to strengthen screening for CF, enhance the identification of CF related to medication use, pay attention to the depressive state of this group, and actively promote the review and management of community drugs.