ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1541555
Risk factors and mediation role of sleep quality for depression in Cognitively Frail Older Adults: A Cross-Sectional Study
Provisionally accepted
- Peking Union Medical College Hospital (CAMS), Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: Aimed to investigate the risk factors associated with depression in community-dwelling older adults with cognitive frailty and to examine the mediating role of sleep quality in the relationship between activities of daily living (ADL) and depression.: A cross-sectional study was conducted using convenience sampling, enrolling older adults with cognitive frailty from six communities in Beijing from July 2023 to December 2023. Cognitive frailty was assessed using the Montreal Cognitive Assessment (MoCA) alongside with the Fried Frailty Phenotype, while depressive symptoms were measured with the Geriatric Depression Scale (GDS-15). Multivariate logistic regression analysis was used to identify risk factors influencing depression, and mediation analysis was employed to explore the mediating effect of sleep quality on the relationship between ADL and depression. Results: Among the 529 elderly participants with cognitive frailty, 128 (24.2%) were found to exhibit depressive symptoms. Multivariate logistic regression identified ADL (Mild Dependence: OR = 176.729 [95% CI 32.427-963.172], P < 0.001; Moderate Dependence: OR = 51.769 [95% CI 12.541-213.697], P < 0.001), loneliness (OR = 13.821 [95% CI 6.095-31.338], P < 0.001), and sleep quality (Suspected Insomnia: OR = 7.310 [95% CI 2.316-23.074], P = 0.001) were significantly associated with depression. Sleep quality was found to mediate the relationship between ADL and depression, accounting for 2.82% of the total effect. Conclusion: Dependence in ADL, loneliness, and poor sleep quality are potential risk factors of depression for cognitive frailty in aging adults. Moreover, sleep quality was found to mediate the relationship between ADL dependence and depressive symptoms.
Keywords: cognitive frailty, Depression, Elderly, Activities of Daily Living, sleep quality
Received: 08 Dec 2024; Accepted: 14 May 2025.
Copyright: © 2025 LAI, Cai, Zhu, Zhang, Zhang, Li, Liu and Huo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
XIAOXING LAI, Peking Union Medical College Hospital (CAMS), Beijing, China
Xiaopeng Huo, Peking Union Medical College Hospital (CAMS), Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.