0744 Self-reported Sleep Quality and Insomnia Symptoms Mediate the Association between Depression and Physical Activity in Older Adults

Abstract

Abstract Introduction Lack of physical activity (PA) is prevalent and leads to multiple chronic conditions in older adults. Understanding factors contributing to low PA may help develop effective and sustainable PA interventions and promote health in older adults. Depressive symptoms and poor sleep quality have been linked with low PA in older adults. Depression can lead to sleep disturbances. In this study, we tested the association between depression and physical activity in community-dwelling older adults and the possible mediating role of sleep quality in the association. Methods We used baseline data collected from an ongoing randomized clinical trial that aims to improve cognitive health in community-dwelling older adults. Participants’ depressive symptoms and level of PA were assessed using the Geriatric Depression Scale Short Form (GDS) and Physical Activity Scale for the Elderly (PASE). Sleep quality and insomnia symptoms were measured by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), respectively. Multiple regression models were used to test the associations between the variables. Baron and Kenny’s approach and the Sobel test were used to examine the mediation effects of participants’ self-reported sleep quality and insomnia symptoms on the association of depression and PA. Results The study sample (n=143) had a mean age of 70 years (SD=6), most were female (n=117, 82%), White (n=77, 54%), and had multiple comorbidities (n=98, 69%). After adjusting for covariates (age, sex, education, income, race, and Body Mass Index [BMI]), higher GDS score was associated with lower PASE (β=-3.58, 95% Confidence Interval [CI]: -7.08, -0.79). Mediation analyses showed that both sleep quality (indirect effect: B=-1.98, CI: -3.80, -0.15) and insomnia symptoms (indirect effect: B=-1.97, CI: -3.94, 0.00) significantly mediated the relationship between depression and PA. Conclusion Depressive symptoms were associated with reduced PA among older adults. Self-reported sleep significantly mediated this association. Older adults with more depressive symptoms had worse sleep quality and more insomnia symptoms, which were associated with decreased PA. Our findings suggest we pay more attention to sleep health in older adults, and people with depression may benefit from sleep-focused interventions to promote PA and health. Support (if any) R00NR016484