The moderating role of depressive symptoms in the relationship between sleep duration and psychological resilience among Chinese old adults with multiple chronic conditions

Objective: Many researches showed that psychological resilience was associated with sleep duration and depressive symptoms among the elderly. But the mechanisms underlying the relationship among old adults with multiple chronic conditions (MCC) remain unclear. This cross-sectional study aimed to explore the relationship among sleep duration, depression and psychological resilience among old adults with MCC in China and further explore the mediating role of depression between sleep duration and psychological resilience. Methods: This study included 2339 older adults with MCC from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Participants completed questionnaires that assessed sleep duration, depression and psychological resilience. We used SPSS Process 4.0 to investigate the relationship between sleep duration, depression and psychological resilience, adjusting for a range of potential covariates and a bootstrapping sample test to examine the potential moderating role of psychological resilience in these relationships. Results: Mean psychological resilience score was (15.60 ± 2.33) (range: 5-25). Sleep duration ( r = 0.129, P < 0.01) and depressive symptoms ( r = -0.547, P < 0.01) were significantly related with psychological resilience. Mediation analysis showed that depressive symptoms played a partially mediating role between sleep duration and psychological resilience, with the indirect effect of 0.114 (95% CI : 0.037-0.194), accounting for 28.29% of the variance in the relationship between sleep duration and psychological resilience. Conclusions: Impaired sleep duration appears to accelerate depression in the elderly with MCC. Sleep duration and psychological resilience were found to be significantly positively correlated among Chinese old adults with MCC. This association was partially mediated by depressive symptoms.