The impact of chronic diseases on depressive symptoms among the older adults: The role of sleep quality and empty nest status.

BACKGROUND: Depression is the most prevalent mental disorder among older adults. This study aimed to explore the mediating effect of sleep quality on the relationship between chronic diseases and depressive symptoms, and the moderating role of empty nest status in the mediating model. METHODS: A cross-sectional survey was conducted among 3637 older adults from Taiyuan, China, using a multi-stage random cluster sampling method. The data was collected with the general questionnaire for the elderly, with the Short Form Geriatric Depression Scale (GDS-15), and the Pittsburgh Sleep Quality Index (PSQI). The Bootstrap program and simple slope method were used to test the mediating effect of sleep quality and the moderating effect of empty nest status. RESULTS: The overall prevalence of depressive symptoms in the population was 33.4%. The mediating effect analysis showed that chronic diseases had a significant direct impact on depressive symptoms in the elderly (ß = 0.431, P < 0.001). Sleep quality as a mediation effect of 43.4% between chronic diseases and depressive symptoms was proven. The further moderating effect found that chronic diseases had a more significant impact on the sleep quality of the elderly who are in the empty nest status than those who are not (ß = -0.431, P < 0.05 ). LIMITATIONS: Given the cross-sectional study, the results cannot explain the causal relationships among the study variables. CONCLUSIONS: Chronic diseases had a major impact on the depressive symptoms of the elderly. Sleep quality mediated the relationship between chronic diseases and depressive symptoms, and the empty nest status moderated the first half of the path in the mediation model. Therefore, to reduce the incidence of the depressive symptoms of the elderly, sleep quality and empty nest status should be the primary concern.

Efficacy of the self-mutual-group model targeting quality of life improvement among empty-nest older adults in Taiyuan, China: an intervention study.

BACKGROUND: In China, more and more older people have encountered a situation called "empty nest." Meanwhile, the health status of empty-nest older adults is an increasing public health concern. This research aims to examine the effectiveness of Self-Mutual-Group (SMG) model in improving quality of life of the empty-nest older adults to provide a scientific evidence for improving their health. METHODS: A prospective intervention study was conducted among empty-nest older adults in Taiyuan, Shanxi. Multi-stage stratified random cluster sampling was employed to selected participants. A total of 396 empty nesters were enrolled as participants, of which 204 and 192 were in the intervention and control group, respectively. The intervention group received a seven-month SMG-based intervention. A participant's quality of life was measured at the baseline and seven months after using the Short Form 36-Item Health Survey (SF-36). RESULTS: No significant difference was found between the intervention and control groups in terms of participant characteristics at baseline (P > 0.05). After the intervention, participants' scores on Mental Component Summary (MCS), Physical Component Summary (PCS), role emotional (RE), vitality (VT), social function (SF), mental health (MH) and general health (GH) increased significantly in the intervention group. Additionally, these scores differed significantly from those in the control group (P < 0.05). CONCLUSION: This study showed that the SMG-based health management is effective in improving quality of life among empty-nest older adults after seven months. TRIAL REGISTRATION: Study on the 'SMG' Health Management Model Based on Community Organization Theory among empty-nest older adults ( ChiCTR1800015884 ). Registration date: 26-04-2018. Retrospectively registered.