Sleep Disturbance as a Catalyst in the Cyclical Link Between Depressive Symptoms and Disability in Instrumental Activities of Daily Living in Older Chinese Adults: Longitudinal Cohort Study

Nov 6, 2025JMIR aging

Sleep Problems May Worsen the Cycle Between Depression and Daily Task Difficulties in Older Chinese Adults

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Abstract

Prior depression significantly predicted subsequent disability in instrumental activities of daily living (IADLs) at T2 (β=0.070, P<.001) and T3 (β=0.074, P<.001).

  • Disability in IADLs at T1 predicted subsequent depression at T2 (β=0.094, P<.001) and T3 (β=0.100, P<.001).
  • Sleep disturbances were identified as a mediating factor in the relationship between prior disability in IADLs and subsequent depression (β=0.062, SE=0.010, P<.001).
  • The mediation effect of sleep disturbances accounted for 50.41% of the total effect of prior disability on later depression.
  • The direct effect of prior depression on subsequent disability in IADLs was not significant after accounting for sleep disturbances (β=0.009, SE=0.018, P=.61).
  • Findings suggest a complex, bidirectional relationship between depressive symptoms and disability in IADLs among older Chinese adults.

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