The mediating roles of social support and sleep quality in the relationship between depression and cognitive function among older adults living with HIV in China

This study aims to investigate the mediating effects of social support and sleep quality on the relationship between depression and cognitive function among older adults living with HIV. This cross-sectional study used convenience sampling to recruit older adults living with HIV from the outpatient department of a designated AIDS hospital in Zunyi, Guizhou Province, China, between January and December 2024. Data collection involved the use of a general data questionnaire (which included demographic and clinical information), the Geriatric Depression Scale (GDS-15), the Montreal Cognitive Assessment (MoCA), the Pittsburgh Sleep Quality Index (PSQI), and the Social Support Scale (SSRS). The data were organized and analyzed via SPSS version 29.0 software and process software. In this study, there was a significant negative correlation between depression and cognitive function among older adults living with HIV. In regression analyses, depression accounted for 47.7% of the variance in cognitive function after adjusting for confounders, which increased to 65.7% when social support and sleep quality variables were included. Mediation analysis indicated that depression had a direct predictive effect on cognitive function, with this direct effect accounting for 35.35% of the total effect (95% CI - 0.332, - 0.055). Furthermore, social support and sleep quality exhibited a chain mediation effect between depression and cognitive function, contributing to an overall indirect effect that comprised 64.65% of the total impact (95% CI - 0.462, - 0.254). In this study, we found that depressive symptoms in older adults living with HIV have a direct effect on cognitive function. Additionally, these depressive symptoms influence the cognitive function of older adults living with HIV through chain mediation involving social support and sleep quality. To effectively delay cognitive decline in this population, enhancing social support and improving sleep quality are key strategies for achieving significant breakthroughs in this area.