Abstract
Psychological distress were found to be associated with chronic conditions and persistent pain. However, few studies explored the underlying pathways between them. This study aimed to analyze the path of chronic conditions and persistent pain on psychological distress through sleep quality and self-rated health. A total of 2,748 rural older people in Shandong, China were included in this study. Path analysis was performed by using Mplus 8.3 to examine the associations between chronic conditions, persistent pain, sleep quality, self-rated health, and psychological distress after adjusting for age, gender, education, and household income. The prevalence of psychological distress among the older adults in this study was 47.49%. Chronic conditions and persistent pain were indirectly associated with psychological distress through six mediating pathways: (1) the path from chronic conditions to psychological distress through sleep quality (β = 0.041, 95%CI: 0.015–0.067) and self-rated health (β = 0.064, 95%CI: 0.038–0.091), respectively, and a chain mediation existed (β = 0.007, 95% CI: 0.000–0.014); (2) the path of persistent pain and psychological distress through sleep quality (β = 0.058, 95% CI: 0.014–0.102) and self-rated health (β = 0.048, 95% CI: 0.000–0.096), respectively, also the chain mediation found (β = 0.009, 95% CI: 0.005–0.014). Psychological distress was associated with chronic conditions and persistent pain through decreased sleep quality and self-rated health among Chinese rural older people. Multi-pronged targeted intervention should be taken for older adults with chronic conditions and persistent pain.
Highlights
Population aging is accelerating worldwide, especially in China, where the total older population will exceed 400 million and the proportion of older adults will exceed 30% by 2050 [1]
There were 38.8% of Chinese rural seniors had a high degree of psychological distress (PD), which was higher than the rate of urban older adults (22.2%) [2]
This study was based on the Shandong Rural Elderly Health Cohort (SREHC), an ongoing longitudinal study conducted in the second-most populous province in China
Summary
Population aging is accelerating worldwide, especially in China, where the total older population will exceed 400 million and the proportion of older adults will exceed 30% by 2050 [1]. There were more than one-third of the Chinese older population had a high risk of severe psychological distress (PD) symptoms [2]. Previous studies found that rural older adults had worse mental health than. Path Analysis of Psychological Distress those in urban areas [4, 5]. There were 38.8% of Chinese rural seniors had a high degree of PD, which was higher than the rate of urban older adults (22.2%) [2]. Previous studies demonstrated that PD was associated with a high risk of suicide ideas, plans, and behaviors, especially among the older population [6,7,8]. Exploring risk factors and their pathways to PD is critical to improving mental health, preventing adverse health outcomes, and reducing mortality
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