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To explore the longitudinal mediating role of cognitive function in the relationship between depression and activities of daily living (ADL) among individuals aged 60 and above in China, as well as the moderating effect of sleep quality.
Data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2018 (T1) and 2020(T2) were analyzed. The Center for Epidemiologic Studies Depression Scale (CES-D10), the Mini-Mental State Examination (MMSE), and the ADL scale were used for measurement. Descriptive statistics and correlation analyses were conducted using STATA 18.0 and SPSS 26.0, while mediation and moderated mediation models were constructed and analyzed using Model 4 and Model 59 in the Process 4.0 program.
T1 depression significantly negatively predicted T2 ADL (r=-0.247, P <0.01). Both T2 cognitive function and T2 sleep quality significantly positively predicted T2 ADL (r=0.227, P < 0.01; r=0.131,P < 0.01). T2 cognitive function served as a longitudinal mediator between T1 depression and T2 ADL, with a mediation effect value of 0.022 (95%CI: -0.027 to -0.018), accounting for 14.5% of the total effect. T2 sleep quality moderated all paths in the mediation model (β=-0.018, P < 0.05; β=0.040, P < 0.001; β=-0.034, P < 0.001).
Depression reduces the ability of elderly individuals to perform daily activities by affecting cognitive function. Improving sleep quality can enhance the impact of depression on cognitive function, and can mitigate the effects of depression and cognitive function on ADL.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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