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. 2025 Jul 2;25(1):440.
doi: 10.1186/s12877-025-06089-z.

Impact of socioeconomic status on obesity in older adults: the suppressive effect of social support and sleep quality

Xi Yang  1 , Xi Gao  2 , Yang Shu  1 , Lei Li  3 , Ying Xiong  4 , Xueyan Zhou  5 , Wanyanhan Jiang  1 , Qun Sun  6 , Chengchao Zhou  7 , Lian Yang  8
Affiliations

Impact of socioeconomic status on obesity in older adults: the suppressive effect of social support and sleep quality

Xi Yang et al. BMC Geriatr. .

Abstract

Background: With the acceleration of population aging, the problem of obesity among older adults is becoming increasingly prominent, representing a major public health problem affecting the health of older adults. In recent years, socioeconomic status(SES) has become a hotspot in research into the mechanisms influencing obesity(OB). However, few studies have explored the process and mechanism of action by which SES affects obesity.

Methods: The sample consisted of 5,576 older adults (≥ 65 years), from a large cross-sectional study conducted in Deyang City, China. Different factors associated with OB in older adults were assessed using χ2 test. Pearson correlation analysis and the SPSS function "PROCESS macro" were used for correlation and serial multiple mediation analysis, respectively, to analyze the relationship between SES and OB, and the mediating role of social support and sleep quality.

Results: The prevalence of obesity among older adults aged ≥ 65 years was 11.05%. The risk of obesity was higher among older adults who were women, relatively young, less educated, non-smokers, or with chronic diseases. SES directly affects obesity (SE = 0.187, 95% CI: 0.105, 0.270), accounting for 88.21% of the total effect. Additionally, social support and sleep quality were found to mitigate the negative effect of high SES on obesity (SE = - 0.025, 95% CI: - 0.045, - 0.006), resulting in a suppressing effect that accounts for 11.79% of the total effect.

Conclusions: Greater social support and sleep quality lower the obesity risk associated with SES in older adults. Therefore, targeted prevention, control, and intervention measures, such as increasing social support and improving sleep quality, can be applied based on the characteristics of older adults of different socioeconomic statuses to minimize the socioeconomic status-associated obesity risks and thus achieve the goal of reducing obesity.

Keywords: Obesity in older adults; Sleep quality; Social support; Socioeconomic status; Suppressing effect.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Medical Ethics Committee of the Affiliated Hospital of Chengdu University of Chinese Medicine (Approval no.2023KL-011). All older adult study subjects obtained their own consent to participate in the study and signed an informed consent form. In the case of incapacitated older subjects, their consent and that of their guardians were obtained and confirmed by both signatures. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Theoretical modeling of the relationships between socioeconomic status (SES), social support, sleep quality, and obesity (OB). The control variables are sex and age
Fig. 2
Fig. 2
Chain mediation model of SES and OB. Path coefficients are expressed as standardized regression coefficients, *P < 0.05, **P < 0.001, where higher PSQI scores indicate poorer sleep quality. The control variables are sex and age
See this image and copyright information in PMC

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