Structural Relationships Between Depression, Perceived Stress, Sleep Quality, and Quality of Life: Evidence from Iranian Elderly

Abstract

Objectives: This study tested structural relationships between depression, perceived stress, sleep quality, and quality of life through path analysis. Methods: In this cross-sectional study, 360 elderly Iranian people were selected using multistage cluster sampling from April 2 to December 6, 2018. The instruments included a demographic form, the geriatric depression scale (GDS), the quality of life scale (QOLS), the perceived stress scale (PSC), and the Pittsburgh sleep quality index (PSQI). To analyze the data, the researchers used SPSS-21, LISREL-8.80, and the Sobel test. Results: The results showed that depression had a significant direct effect on sleep quality, but not on stress. The effect of depression and stress on the quality of life was found to be 45%. Further, depression, stress, and sleep quality had a significant direct effect on the quality of life. This could explain 85% of changes in the quality of life of the elderly. Moreover, depression with the mediating variable of sleep quality had an indirect effect on the quality of life. Conclusions: It can be concluded that providing conditions for a high quality of life level and a good sleep status can help to improve mental health in elderly people. However, further experimental and longitudinal research is needed in this respect, and it is necessary to study other mediating factors on quality of life in elderly