The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China

Yunyi Wu; Sangsang Li; Dan Han; Mei Zhang; Jie Zhao; Hui Liao; Ying Ma; Chaoyang Yan; Jing Wang

doi:10.3389/ijph.2023.1605678

The Mediating Role of Depression in Association Between Total Sleep Time and Instrumental Activities of Daily Living in China

Int J Public Health. 2023 Apr 4:68:1605678. doi: 10.3389/ijph.2023.1605678. eCollection 2023.

Authors

Yunyi Wu¹, Sangsang Li¹, Dan Han¹, Mei Zhang¹, Jie Zhao¹, Hui Liao¹, Ying Ma¹, Chaoyang Yan¹, Jing Wang^{1

2

3}

Affiliations

¹ Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China.
³ Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Objectives: This study aims to investigate the mediating role of depression and the moderating effect of gender in the relationship between total sleep time (TST) and instrumental activities of daily living (IADL) in middle-aged and elderly people (aged 45 or above). Methods: The data used in this study is from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 10,460 respondents. Associations between TST, IADL, depression, and gender were analyzed using logistic regression and Karlson, Holm, and Breen (KHB) methods. Results: Short (OR = 1.42, 95% CI = 1.28-1.58 of ≤6 h) and long TST (OR = 1.16, 95% CI = 1.02-1.32 of 8-9 h; OR = 1.35, 95% CI = 1.19-1.54 of >9 h) were both associated with IADL. The mediation effect analyses observed that depression explained 64.80% of the total effect of short TST (≤6 h) and IADL, but was insignificant in long TST (8-9 h and >9 h). Meanwhile, gender has moderating effects on the mediation effect model. Conclusion: The study suggests that health interventions that focused on the dimensions of TST and depression are crucial for preventing functional disability while accounting for gender differences.

Keywords: IADL disability; depression; gender difference; panel data; total sleep time.

MeSH terms

Activities of Daily Living*
Aged
China / epidemiology
Depression* / epidemiology
Humans
Longitudinal Studies
Middle Aged
Sleep Duration

Grants and funding

This research was supported by: (1) Research on dynamic optimization of coping strategies on health poverty risk for rural older households, funded by National Science Foundation of China (grant numbers 72074086); (2) Research on multi-dimension risk identification of health poverty vulnerability of the elderly in rural areas and targeted poverty alleviation strategy, funded by National Science Foundation of China (grant numbers 71673093); (3) Research on influence mechanism and promotion strategy of rural household health capacity on risk of failing back to poverty due to disease, supported by the Fundamental Research Funds for the Central Universities, HUST, China (grant numbers 2022WKZDJC009).