Abstract
This study aims to evaluate the association of depressive symptoms and their severity with overall disability and disability domains, and to assess temporal changes in these associations. Data from the National Health and Nutrition Examination Survey (NHANES) 2013-2018 were analyzed. A total of 15,565 participants were included, with 1383 (8.19 %) reporting depressive symptoms. Depressive symptoms were strongly associated with overall disability (aOR = 7.82; 95 % CI = 6.27, 9.75; p < 0.001) and with six specific domains (aOR = 2.54 for hearing, 2.84 for seeing, 10.53 for concentrating, 4.42 for walking, 6.01 for dressing or bathing, and 7.36 for doing errands alone; all p < 0.001). Each unit increase in PHQ-9 score was linked to a 21 % increase in the odds of overall disability (aOR = 1.21; 95 % CI = 1.19, 1.23; p < 0.001) and to a 9 %-25 % increase in the odds of domain-specific difficulties. Both cognitive-affective (aOR = 1.35; 95 % CI = 1.30, 1.40) and somatic scores (aOR = 1.36; 95 % CI = 1.33, 1.39) were associated with overall disability and domain-specific difficulties, with each unit increase linked to 13 %-45 % higher odds. Temporal analysis indicated that depressive symptoms are linked to a higher prevalence of disability, with this association persisting and slightly increasing over time. Our findings indicated the association between depressive symptoms and disability. Future studies should further replicate our results and evaluate the mechanisms underlying this phenomenon.