The relationship between self-assessment living standard and mental health among the older in rural China: the mediating role of sleep quality

Background and objectiveMental health imbalance are the main cause of anxiety, depression and happiness reduction in the older. Self-assessment living standard and sleep quality are both influencing factors of mental health. Meantime, self-assessment living standard has an impact on sleep quality. But there's no research on the relationship between the three, we conducted this study to explore the relationship between self-assessment living standard and mental health and the mediating role of sleep quality among the older in rural areas of China.MethodsUsing typical field sampling method, M County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires enclosing respondents' sociodemographics information, 12 Items General Health Questionnaire (GHQ-12) and Pittsburgh Sleep Quality Scale (PSQI), face-to-face interviews were used to collect data. Bootstrap test was used for data analysis.ResultsThe results showed that the age of the respondents ranged from 60 to 99 years, with an average age of (66.53 +/- 6.77) years, the proportion of the older with a tendency to mental health problems was 24.7%. Most of the older people's self-assessment living standard was normal (average score was 2.89 +/- 0.726), accounting for 59.3% of the total. The average sleep quality score was (6.97 +/- 4.066), and 2.5% of the respondents reported serious sleep problems. older with low self- assessment living standards were more likely to report a higher propensity for psychological problems (beta = 0.420, P < 0.001) and poorer sleep quality (beta = 0.608, P < 0.001) than older with high self- assessment living standards. Mental health of the older may be related to sleep quality (beta = 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (beta = 0.071, P < 0.001).ConclusionMental health is associated with self-assessment living standard, with this association mediated by sleep quality. A reasonable mechanism needs to be established to improve self-assessment living standard and sleep quality.