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. 2025 Mar 28:13:1543474.
doi: 10.3389/fpubh.2025.1543474. eCollection 2025.

The mediating roles of activities of daily living and depression in the relationship between pain and sleep duration among rural older adults in China: a cross-sectional study

Yanxu Liu  1 , Guoqi Fu  1 , Yulin Chai  1 , Cailing Xue  1 , Qi Song  1 , Sheng Luo  1 , Li Luo  2
Affiliations

The mediating roles of activities of daily living and depression in the relationship between pain and sleep duration among rural older adults in China: a cross-sectional study

Yanxu Liu et al. Front Public Health. .

Abstract

Background: As the population ages, the health of rural older adults is of increasing concern to society. Pain, decreased activity of daily living, depression, and sleep are important factors affecting the quality of life of older adults. This study aimed to explore the complex relationship between pain, activity of daily living, depression, and sleep in rural older adults, with the goal of providing new perspectives and intervention strategies to improve sleep quality.

Methods: This study was based on the data from the 2020 China Health and Retirement Longitudinal Study, and rural older adults aged 60 years and above were selected as the study subjects, with a final sample size of 5,352. Stata 18.0 and SPSS 27.0 software were used for statistical analysis, and t-tests, analysis of variance (ANOVA), and Pearson correlation analyses were used for one-way analyses, and PROCESS 4.2 was used for mediation effect analysis and testing.

Results: Pain in older adults was negatively correlated with sleep duration (r = -0.212) and positively correlated (p < 0.001) with impairment to activity of daily living (r = 0.339) and depression (r = 0.355). The mediation test reported that pain in older adults had a direct effect on sleep duration (95% CI: -0.076 to -0.043), with activity of daily living (95% CI: -0.014 to -0.004) and depression (95% CI: -0.026 to -0.017) acting as chained mediators between the two.

Conclusion: This study reveals the interrelationships between pain, activity of daily living, depression and sleep in rural older adults. It is recommended that medical resources be strengthened, health awareness be increased, community care services be improved, recreational activities be provided, and family emotional support be encouraged to improve the health and quality of life of older adults.

Keywords: activities of daily living; depression; pain; rural older adults; sleep duration.

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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
Flow chart of sample inclusion.
Figure 2
Figure 2
A chain-mediated model of pain on sleep duration. **p < 0.01.
See this image and copyright information in PMC

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