The impact of sociodemographic, health status and health behavior factors on depression and quality of life in older adults

BMC Public Health. 2025 Sep 24;25(1):3112. doi: 10.1186/s12889-025-24506-1.

ABSTRACT

BACKGROUND: This study aimed to investigate the determinants of depression and quality of life (QoL), emphasizing sociodemographic, health status, and health behavior factors. Additionally, it focused on depression as a mediator in the relationship between sleep disturbance and QoL.

METHOD: This cross-sectional study involved 365 elderly individuals aged 60-90 years in a district of Türkiye, conducted from October 1 to November 15, 2024. The data collection involved face-to-face surveys at Family Health Centers using convenience sampling. Researchers visited these centers periodically, distributed questionnaires to willing elderly participants, and observed the completion of forms. The WHO Quality of Life Assessment (WHOQOL-AGE), the Geriatric Depression Scale-15 (GDS-15), the Jenkins Sleep Scale (JSS), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) were used to assess QoL, depression, sleep disturbances, and physical activity. Hierarchical regression analyses identified determinants of depression and quality of life, while mediation analysis explored depression’s role in the relationship between sleep disturbances and QoL.

RESULTS: The study revealed a high frequency of depression (38.4%) among older adults, significantly associated with low QoL. Hierarchical linear regression analysis indicated that age negatively impacted QoL (β= -0.150) while higher family income positively influenced it (β = 0.189). Conversely, higher education level was negatively associated with depression (β= -0.143). Additionally, being overweight or obese adversely affected QoL (β= -0.113) and increased depression risk (β = 0.099). Chronic illness and dependency also contributed positively to depression (β = 0.136; β = 0.125 respectively). Furthermore, physical activity enhanced QoL (β = 0.241) but is negatively correlated with depression (β= -0.242), while sleep disturbance detrimentally affected both QoL (β= -0.123) and increased depression (β = 0.175) risk. Importantly, mediating effect analysis results showed that depression acted as a complete mediator in the relationship between sleep disturbance and QoL (β= – 0.202, Boot 95% CI [- 0.327, – 0.088]).

CONCLUSION: This study showed that, in addition to sociodemographic factors, physical health status and health behaviors influenced both depression and QoL. Notably, depression fully mediated the relationship between sleep disturbance and QoL. These results emphasized the need to consider various factors in efforts to reduce depression and enhance QoL in older individuals. Additionally, interventions targeting sleep disturbance should prioritize strategies to alleviate depression, as this is crucial for improving overall QoL.

PMID:40993639 | DOI:10.1186/s12889-025-24506-1