The association between sleep quality and psychological distress among older Chinese adults: a moderated mediation model

Abstract

Background Previous research has found a link between sleep quality and psychological distress. However, the underlying mechanisms of this connection have still not been well explored. The aim of this study was to examine the roles of activities of daily living (ADL), physical activity, and perceived social support in the link between sleep quality and psychological distress among older adults. Methods Three thousand two hundred fifty valid individuals (aged 60 years or above) participated in face-to-face questionnaire-based surveys. Older individuals were assessed using the Pittsburgh Sleep Quality Index, Barthel Index, International Physical Activity Questionnaire, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. The PROCESS macro developed by Hayes was used to conduct moderated mediation analysis. Results In older adults, sleep quality had a substantial direct influence on psychological distress. ADL mediated the association between sleep quality and psychological distress. Physical activity significantly reduced ADL’s mediating influence on the relationship between sleep quality and psychological distress. Furthermore, perceived social support moderated the direct relationship between sleep quality and psychological distress, as well as the second half of the mediating effect of the ADL. Moreover, physical activity and perceived social support were preventive factors that might successfully mitigate the detrimental effects of poor sleep quality on ADL and psychological distress. Conclusions The findings contribute to existing understanding by clarifying the fundamental mechanisms that link sleep quality and psychological distress. These results may provide a valuable reference to the Chinese government for improving mental health in older individuals.

Relationship between Perceived Social Support and Sleep Quality among Older Men in Guangdong Province, China: The Mediating Role of Rumination and the Moderating Role of Physical Activity

“…These findings are consistent with results from a previous study [8]. Perceived social support improves the health status and prolongs the lifespan of a person by modulating the body's internal immune function.…”

“…The physical and mental health disorders of older adults are a major public health concern. Previous studies report that various psychological factors such as rumination, perceived social support, and sleep quality are correlated with depression incidence in older adults [7][8][9]. Several studies report that active physical activity effectively mediates the morbidity and mortality of cardiovascular diseases and ameliorates chronic physical diseases [10][11][12], as well as increases life expectancy thus improving mental health [13].…”

The impact of socioeconomic status and sleep quality on the prevalence of multimorbidity in older adults

“…Epidemiological studies have shown an association between poor sleep quality and perennial chronic diseases in older adults, such as type 2 diabetes, hypertension, coronary heart disease, and chronic obstructive pulmonary disease ( 20 , 21 ). Sleep quality is also associated with psychological distress, and older adults who have poor sleep quality are more likely to experience various mental health problems ( 22 ). Therefore, we hypothesize that poor sleep quality is related to the prevalence of multimorbidity in older adults.…”

Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas

“…With the increasing trend of aging, China will have 264.02 million older adults over the age of 60 by the end of 2020. 1 Despite the fact that China’s rapid economic growth has helped to improve populations’ overall health and average life expectancy. However, one of the most prominent issues today is the health disparity between urban and rural areas.…”