Association between depression and quality of life in older adults with type 2 diabetes: A moderated mediation of cognitive impairment and sleep quality.

BACKGROUND: The acceleration of aging and the increase in life expectancy have resulted in an increasing number of older adults developing physical and mental comorbidities. We examined the association between depression and quality of life (QoL) using cognitive impairment (COI) as a mediator and sleep quality (SQ) as a moderator among older adults with type 2 diabetes. METHODS: A total of 2646 participants from Weifang, Shandong, China completed the survey. Their depression, cognitive function, SQ, and QoL were assessed. PROCESS was used to investigate mediating and moderating effects. RESULTS: COI mediated the association between depression and QoL (indirect effect = -0.1058, bootstrapped 95 % CI [-0.1417, -0.0725]). Moderated mediation analyses indicated that SQ moderated the first half of the pathway of depression's impact on QoL through COI (moderating effect = -0.1128, bootstrapped 95 % CI [-0.1981, -0.0348]). Depression negatively impacted cognitive function in participants with poor (vs. better) SQ. LIMITATIONS: First, multiple assessment tools should be considered to increase objective assessment. Second, the cross-sectional design limited our ability to make causal inferences. Third, additional diabetes-related variables should be included to explore this relationship. Finally, the pathways of influence and mechanisms of action of COI in older adults should be explored further. CONCLUSION: Depression could impair the QoL of older adults by aggravating their COI. Fortunately, improving patients' SQ may undermine this negative effect. These findings may play an integral role in promoting the psychiatric health of older adults with type 2 diabetes.

Relationship Between Physical Exercise and Cognitive Impairment Among Older Adults with Type 2 Diabetes: Chain Mediating Roles of Sleep Quality and Depression.

Objective: Although physical exercise has been shown to boost physical, psychological, and psychiatric conditions in older adults, there is a relative lack of research on the mechanisms involved in this process for older adults with type 2 diabetes mellitus (T2DM). We thus evaluated whether sleep quality and depression mediated the relationship between physical exercise and cognitive impairment in older adults with T2DM by focusing on the exercise-physiology-psychology and psychiatry connection. Methods: Self-reported data were collected from 2646 older adults with T2DM in Weifang, Shandong, China. Regression and bootstrap analyses were conducted to explore the chain mediator model including physical exercise, cognitive impairment, sleep quality, and depression. Results: Engaging in physical exercise (coefficient = -0.6858, p < 0.001), high levels of sleep quality (coefficient = -0.3397, p = 0.015), and low levels of depression (coefficient = 0.3866, p < 0.001) were significantly associated with a low level of cognitive impairment. Sleep quality and depression mediated the chain effect between physical exercise and cognitive impairment (total effect = -1.0732, 95% CI [-1.3652, -0.7862]; direct effect = -0.6858, 95% CI [-0.9702, -0.3974]; indirect effect = -0.3875, 95% CI [-0.5369, -0.2521]). Conclusion: Physical exercise may improve sleep quality in older adults with T2DM, alleviating depression and delaying the development of cognitive impairment. Physical exercise can enhance patients' ability to resist depression and cognitive impairment, and creating comfortable sleep environments can also reinforce the effects of this process. These findings have important implications for promoting healthy aging in older adults with T2DM.

The Effect of the Irreversible Inequality on Pro-social Behaviors of People With Disabilities.

Inequalities have always been central to psychology, sociology and related fields such as social policy, gender studies, critical race studies, and human geography. Although inequality affects pro-social behaviors, there are still some controversies over this issue among people with disabilities. The current study aimed to investigate pro-social behaviors of people with disabilities and the effect of the irreversible inequality on pro-social behaviors. A dictator game was used to explore the difference of pro-social behaviors between people with disabilities and people without disabilities, when facing intra- or inter-group members. The results showed that compared to people with disabilities, people without disabilities were likely to show more pro-social behaviors. People with disabilities preferred intra-group cooperation, while people without disabilities preferred inter-group cooperation. Indeed, the intra-group cooperation was significantly greater than the expected cooperation of the intra-group members for people with disabilities. When facing the inter-group members, people without disabilities showed more than expected, that others would cooperate with them. These findings indicated that social avoidance was a common phenomenon for people with disabilities in China, but the situation would be different when they faced different groups. In addition, irreversible inequality could influence individuals' cooperative strategies when facing individuals in a different status.

Social Interaction Patterns of the Disabled People in Asymmetric Social Dilemmas.

The social participation of the disabled people is unsatisfactory and low, one of the reasons often overlooked but of great importance may lie in the disparate patterns of social interaction between the disabled people and the abled people. The current study respectively recruited 41 and 80 disabled people in two experiments and adopted give-some games and public good dilemma to explore social interaction patterns between the disabled abled people. The results were as follows: (1) the disabled people preferred to interact with the disabled people and the abled people preferred to interact with the abled people. (2) The disabled abled people had higher cooperation, satisfaction and sense of justice when interacting with the disabled people than interacting with the abled people. (3) Advantage in the number of the disabled people could reverse their disadvantage in the identity. These results are of important practical value, which provides related theoretical support for the disabled people's federation and communities when carrying out activities for the disabled people.