Background: Although previous research has identified psychological disorders such as depression, stress and anxiety as key modifiable risk factors for cognitive decline including dementia, the association between depression and subjective cognitive in cancer survivors, has not been extensively studied, particularly in older survivors.

Methods: Data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) for participants aged 65 years and older with a history of cancer diagnosis were analyzed. Multivariable logistic regression was used to examine the independent association between self-reported clinical depression and subjective cognitive decline (SCD) adjusting for demographic and behavioral factors. Further, we performed a stratification analysis to determine if the association differs by sex. All analyses were weighted.

Results: Among the 12,170 participants in this study, the prevalence of self-reported clinical depression and SCD were 16.8% and 21.5%, respectively. In the overall sample, the odds of experiencing SCD were significantly higher for cancer survivors with depression than those without a history of clinical depression (0R=2.95, 95% CI:2.35-3.71). Results of the stratification analyses showed that among male survivors, those with depression had significantly greater odds of experiencing SCD compared to those without depression (OR=2.4I, 95% CI:1.71-3.40). Likewise, among female survivors, the odds of experiencing SCD were significant greater for those with depression than those without depression (OR=3.36, 95% CI:2.58-4.44).

Conclusion: Future longitudinal studies are needed to explore the moderating effect of psychological disorders including depression on the relationship between subjective cognitive decline and the risk of developing dementia in cancer survivors.