Horticultural therapy (HT), a widely adopted non-pharmacological intervention, mitigates depressive symptoms among older adults. Given China’s aging population, examining the effect of HT on depressive symptoms among older adults in nursing homes is of practical significance.

Based on three-wave longitudinal panel data from 2022 to 2024 among older adults in Shanghai J Nursing Group facilities, propensity score matching was employed to control for confounding variables and analyze the mechanism of HT’s effect on depressive symptoms among older adults in nursing homes.

HT had a significant predictive effect on depressive symptoms among older adults in nursing homes (β=-1.582, P<0.001). Psychological resilience partially mediated the relationship between HT and depressive symptoms (β=-0.501, 95% CI: -0.772~-0.287), accounting for 31.7% of the total effect. Sleep quality moderated the impact of HT on psychological resilience (β=0.077, P<0.05).

Government departments should promote the integration of HT into standard elderly care protocols and establish a combined model focusing on horticultural therapy, psychological resilience, and sleep health management to improve psychological well-being among older adults in nursing homes.