Church attendance mediates the association between depressive symptoms and cognitive functioning among older Mexican Americans

Background. The objective of this study was to examine how the effect of depressive symptoms on cognitive function is modified by church attendance. Methods. We used a sample of 2759 older Mexican Americans. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline, 2, 5, 7, and 11 years of follow-up. Church attendance was dichotomized as frequent attendance (e.g., going to church at least once a month) versus infrequent attendance (e.g., never or several times a year). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D; score >= 16 vs < 16). General linear mixed models with time-dependent covariates were used to explore cognitive change at follow-up. Results. In unadjusted models, infrequent church attendees had a greater decline in MMSE scores (drop of 0.151 points more each year, standard error [SE] = 0.02, p < .001) compared to frequent church attendees; participants having CES-D scores >= 16 also had greater declines in MMSE scores (drop of 0.132 points more each year, SE = 0.03, p < .001) compared to participants with CES-D score < 16 at follow-up. In fully adjusted models, a significant Church attendance X CES-D X Time interaction) = .001) indicated that, among participants with CES-D scores >= 16, infrequent church attendees had greater decline in MMSE scores (drop of 0.236 points more each year, SE = 0.05, p < .001) compared to frequent church attendees at follow-up. Conclusion. Church attendance appears to be beneficial for maintaining cognitive function of older persons. Church attendance moderates the impact of clinically relevant depressive symptoms on subsequent cognitive function.