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. 2023 Jun 27:11:1163867.
doi: 10.3389/fpubh.2023.1163867. eCollection 2023.

Depression, anxiety and insomnia in Chinese older adults and their family caregivers during the COVID-19 pandemic: an actor-partner interdependence model approach

Kai-Rong Ding #  1   2 , Wen-Qi Xu #  1 , Yong-Yi He  1   2 , Jia-Hui Hu  1   2 , Wen-Yan Tan  1 , Jing Liao  3 , Cai-Lan Hou  1 , Fu-Jun Jia  1   2 , Shi-Bin Wang  1
Affiliations

Depression, anxiety and insomnia in Chinese older adults and their family caregivers during the COVID-19 pandemic: an actor-partner interdependence model approach

Kai-Rong Ding et al. Front Public Health. .

Abstract

Aims: This study aimed to explore the dyadic effects of depression and anxiety on insomnia symptoms in Chinese older adults and their caregivers living in a community setting.

Methods: Data were collected from 1,507 pairs of older adults and their caregivers who were in the Guangdong Mental Health Survey in China. The 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder module 7 (GAD-7), and Insomnia Severity Index (ISI) were used to measure depression, anxiety, and insomnia symptoms. Actor-Partner Interdependence Models (APIM) were used to determine whether anxiety or depression symptoms predicted individual or dyadic insomnia.

Results: Older adults' and caregivers' depression and anxiety had significant positive correlations with their own and their caregivers' insomnia symptoms (all P < 0.001). Actor effects were found between depression and insomnia symptoms in both older adults and caregivers (B = 0.695, P < 0.001; B = 0.547, P < 0.001, respectively), with one significant partner effects (B = 0.080, P = 0.007). Actor effects were also found between anxiety and insomnia symptoms in both older adults and caregivers (B = 0.825, P < 0.001; B = 0.751, P < 0.001, respectively), with one significant partner effects (B = 0.097, P = 0.004). However, the caregivers' depression and anxiety were not associated with older adults' insomnia symptoms in the APIM analyses.

Conclusions: Older adults and their caregivers had an interrelationship between psychological distress and insomnia. Consequently, healthcare providers might consider involving dyads when designing programs to reduce insomnia and improve psychological distress for family caregivers.

Keywords: actor-partner interdependence model; anxiety; depression; insomnia; older adults.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Actor–partner interdependence model of depression and insomnia within older adults-caregivers dyads. Model (A) is a crude model without covariates. Model (B) is an adjusted model controlling age, gender and region. Standardized coefficients (β) are presented on straight lines with single arrow and correlation coefficients are reported on curves with double-headed arrows. A solid line and dotted line represent significant path and non-significant one respectively. *p < 0.01; **p < 0.001.
Figure 2
Figure 2
Actor–partner interdependence model of anxiety and insomnia within older adults-caregivers dyads. Model (A) is a crude model without covariates. Model (B) is an adjusted model controlling age, gender and region. Standardized coefficients (β) are presented on straight lines with single arrow and correlation coefficients are reported on curves with double-headed arrows. A solid line and dotted line represent significant path and non-significant one respectively. *p < 0.01; **p < 0.001.
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