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

Objective: Psychological problems are the main cause of anxiety, depression and happiness reduction in the elderly. Mental health imbalance not only has a direct impact on physical health, but also has an indirect impact on social support, quality of life, and brings a huge burden of disease. The purpose of this study was to explore the relationship between self- assessment living standard and mental health and the mediating role of sleep quality among the elderly in rural areas of China. Methods: : Using typical field sampling method, Mengcheng County, Anhui Province was selected as the investigation site, and a total of 1223 respondents were selected. With the help of questionnaires, face-to-face interviews were used to collect data. Self- assessment living standard can be divided into five subjective dimensions. Mental health was evaluated by 12 Items General Health Questionnaire (GHQ-12). Sleep quality was measured by Pittsburgh Sleep Quality Scale (PSQI). Bootstrap test was used for data analysis. Results: : The results showed that 24.7% of the elderly had a tendency to have mental health problems, which was similar to 18.5%-24.47% of the general elderly population. 59.3% of the elderly had a general self-assessment living standard (average score was 2.89 ± 0.726). The average sleep quality score was (6.97 ± 4.066), and 2.5% of the respondents reported serious sleep problems. Elderly with low self- assessment living standards were more likely to report a higher propensity for psychological problems (β=0.420, P < 0.001) and poorer sleep quality (β= 0.608, P < 0.001) than elderly with high self- assessment living standards. Mental health of the elderly may be related to sleep quality (β= 0.117, P < 0.001). In addition, the effect of self- assessment living standard on mental health was significantly mediated by sleep quality (β= 0.071, P < 0.001). Conclusions: : Mental 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.