Association Between Sleep Quality and Depressive Symptoms in Community-Dwelling Older Adults: The Mediating Role of Loneliness
Abstract
To examine the association between sleep and depressive symptoms among community-dwelling older adults and whether loneliness mediates this association.
Methods
Using a multistage sampling approach, we enrolled participants aged 60 years or older from two communities in Chengdu, China. A questionnaire was used to collect basic information, including age, sex, etc., from the participants. In addition, loneliness, depressive symptoms, and sleep quality were assessed using a short-form University of California Los Angeles Loneliness Scale (ULS-8), the 10-item version of Center of Epidemiologic Studies Depression Scale (CESD-10), and the Pittsburgh Sleep Quality Index (PSQI), respectively. The Spearman rank correlation coefficient was employed to assess the correlations among social sleep, loneliness, and depression symptoms. Generalized structural equation modeling was used to assess the mediating effect of loneliness between sleep and depressive symptoms.
Results
Of the 1377 participants, 32.03% (441) experienced loneliness and 30.57% (421) had depressive symptoms, with the median and interquartile range of their sleep quality being 6 (3, 9). Correlation analysis revealed statistically significant associations between sleep quality, loneliness, and depressive symptoms (P < 0.001). Generalized structural equation modeling analysis revealed that loneliness had a partial mediation effect on the association between sleep quality and depressive symptoms (b = 0.075; 95% CI, 0.025-0.125; P < 0.05), accounting for 44.38% of the total effect (95% CI, 0.258-0.630; P < 0.001).
Conclusion
Poor sleep quality is associated with a higher risk of depressive symptoms in community-dwelling older adults, with loneliness mediating the association. Further research on improving the sleep quality to mitigate depressive symptoms in older adults is warranted. Special attention should be given to older adults experiencing both poor sleep and loneliness.
Keywords: Older adults, Sleep, Depression, Loneliness
Full Text:
PDFReferences
Ministry of Civil Affairs of the People's Republic of China. Statistical bulletin on the development of civil affairs in 2023. (2024-08-30) [2024-09-22]. https://www.mca.gov.cn/n156/n2679.
National health commission office. Notice on carrying out the elderly psychological care action by the national health commission office. (2022-06-20) [2024-09-26]. http://www.nhc.gov.cn/lljks/pqt/202206/c8cfbfd7dd464bc0afc6f55afe170bbb.shtml.
National health commission. Response to the 0092nd proposal of the second session of the 14th national people's congress (2024-07-24) [2024-09-26]. http://www.nhc.gov.cn/wjw/jiany/202408/da39024837194aa 49cf648d90ed1dc7e.shtml.
CUI L, DING D, CHEN J, et al. Factors affecting the evolution of Chinese elderly depression: a cross-sectional study. BMC Geriatrics, 2022, 22(1): 109. doi: 10.1186/s12877-021-02675-z.
KOK R M, REYNOLDS C F, 3rd. Management of depression in older adults: a review. JAMA, 2017, 317(20): 2114-2122. doi: 10.1001/jama. 2017.5706.
World Health Organization. Depression and other common mental disorders: global health estimates. (2017-01-03) [2024-05-09]. https://www.who.int/publications/i/item/depression-global-health-estimates.
Chinese Medical Association, Chinese Medical Journals Publishing House, Chinese Societyof General Practice, et al. Guideline for primary care of major depressive disorder (2021). Chin J Gen Pract, 2021, 20(12): 1249-1260. doi: 10.3760/cma.j.cn114798-20211020-00778.
LIM D C, NAJAFI A, AFIFI L, et al. The need to promote sleep health in public health agendas across the globe. Lancet Public Health, 2023, 8(10): e820-e826. doi: 10.1016/S2468-2667(23)00182-2.
XIONG F, LAI Y Q, TU J X, et al. Epidemiological characteristics of sleep disorders in the Chinese elderly: a meta-analysis. Chin J Evid Based Med, 2019, 19(4): 398-403. doi: 10.7507/1672-2531.201808151.
PAN X B, WANG H X, CAO Y J, et al. Secular trends in sleep conditions in Chinese elderly individuals: a national population-based study. Nat Sci Sleep, 2023, 15: 555-566. doi: 10.2147/NSS.S416084.
DENG M, QIAN M, LV J, et al. The association between loneliness and sleep quality among older adults: a systematic review and meta-analysis. Geriatr Nurs, 2023, 49: 94-100. doi: 10.1016/j.gerinurse.2022.11.013. NIELSON S A, KAY D B, DZIERZEWSKI J M. Sleep and depression in older adults: a narrative review. Curr Psychiatry Rep, 2023, 25(11): 643-658. doi: 10.1007/s11920-023-01455-3.
LI W, SUN H, XU W, et al. Leisure activity and cognitive function among Chinese old adults: the multiple mediation effect of anxiety and loneliness. J Affect Disord, 2021, 294: 137-142. doi: 10.1016/j.jad.2021.07.051.
CACIOPPO J T, CACIOPPO S. The growing problem of loneliness. Lancet, 2018, 391(10119): 426. doi: 10.1016/S0140-6736(18)30142-9.
LEE S L, PEARCE E, AJNAKINA O, et al. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry, 2021, 8(1): 48-57. doi: 10.1016/S2215-0366(20)30383-7.
LIAO F, WANG W, ZHOU B, et al. Longitudinal cohort study on the relationship between sleep duration and depressive symptoms in older people in China. J Sichuan Univ (Med Sci Edi), 2022, 53(1): 109-113. doi: 10.12182/20220160204.
LEE E, CHO H J, OLMSTEAD R, et al. Persistent sleep disturbance: a risk factor for recurrent depression in community-dwelling older adults. Sleep, 2013, 36(11): 1685-1691. doi: 10.5665/sleep.3128.
Refbacks
- There are currently no refbacks.
