ArticleFrontiers in psychology2025
Psychological states mediate the relationship between sleep quality and frailty among older adults.
Article in Frontiers in psychology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Frailty prevalence is high among older adults. While the association between poor sleep quality and frailty is established, the mediating role of psychological states (anxiety/depression) and the moderating influence of multidimensional factors (physiological conditions, dietary habits, and lifestyle factors) on this pathway remain unclear. This study aimed to examine the mediating effects of anxiety and depression on the sleep quality-frailty link and identify moderators of the sleep quality-psychological state relationship among community-dwelling older adults. Methods: A cross-sectional survey was conducted among 900 adults aged ≥60 years in Dongge Community, Nanning, Guangxi. Sleep quality, anxiety, depression, and frailty were assessed using the Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale (HADS-A/HADS-D), and FRAIL scale, respectively. Data on physiological conditions, dietary habits, and lifestyle factors were collected via questionnaire. Parallel mediation and moderated mediation analyses were performed. Results: Mean scores were: HADS-A = 1.00 ± 1.76, HADS-D = 1.32 ± 2.11, PSQI = 6.41 ± 3.22, and FRAIL = 0.96 ± 1.05. Parallel mediation analyses confirmed that both anxiety ( Conclusion: Anxiety and depression significantly mediate the relationship between poor sleep quality and frailty in older adults. Crucially, this mediating pathway via anxiety is modifiable, being attenuated by the absence of bodily pain, frequent consumption of key protein-rich foods, and regular outdoor exercise. These findings highlight potential targets for multi-faceted interventions aimed at mitigating frailty risk by improving sleep and psychological well-being in aging populations.
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