Poor sleep quality and late-life depression among the elderly in urban communities in liaoning, China: A moderated mediation analysis

This study aims to investigate a moderated mediation model in the relationship between poor sleep quality, depressive symptoms, perceived stress, sense of coherence. A cross-sectional survey was conducted from May to July 2015 in Liaoning Province, China. 1050 community residents aged ≥60 years were ultimately chosen to participate. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Epidemiological Studies Depression Scale(CES-D),the Chinese version Perceived Stress Scale(CPSS), and the Sense of Coherence Scale (SOC) were used to estimate sleep quality, late-life depression, perceived stress, and sense of coherence (SOC) respectively. Pearson's correlations and the PROCESS macro were applied to analyze the data. The results showed that perceived stress partially mediated the association between poor sleep quality and depression symptoms (35% proportion mediated). In addition, the effect of poor sleep quality and the effect of perceived stress on late-life depression was moderated by SOC.The current findings indicates that the impact of poor sleep quality on late-life depression through perceived stress can be buffered when the elderly individuals have a high SOC. Interventions should therefore target individuals who are classified as poor sleepers but only have a lower SOC score. However, longitudinal studies should be conducted in future to substantiate these findings. Importantly, this research provides a useful theoretical and methodological approach for prevention of depression among the elderly in urban China.