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· 48 · Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2024年2月
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structural equation model［J］. Front Psychol，2017，8： （本文编辑：姜 鑫）

The impact of sleep quality on quality of life in rural older adults: the

mediating effect of mental health and the moderating role of fall risk

LIU Song，ZHANG Beibei，DING Hong
School of Health Management，Anhui Medical University，Hefei 230032，China
Abstract：This study adopts EQ⁃5D⁃3L，Pittsburgh sleep quality index，GHQ⁃12，and Morse fall scale
（MFS）to investigate older adults in M County and to explore the interaction mechanism between sleep quality
and quality of life of the older adults in rural areas. The mediating and moderating effects were tested by the
Bootstrap method. The results found that mental health partially mediated between sleep quality and quality of
life among older adults（effect size -0.197，95% confidence interval -0.331 to -0.072），with the mediating effect
accounting for 43.8% of the total effect. The mediating effect was affected by the risk of falls（R = -0.020，
P < 0.01），with a more significant effect observed in older adults with a higher risk of falls. Therefore，fall risk
in rural older adults moderates the mediating role of mental health on the association between sleep quality and
quality of life. Reducing fall risks may improve the quality of life among older adults with poor sleep and mental
health.
Key words：mental health；sleep quality；quality of life；fall risk；the elderly；rural areas