Abstract: Objective　To investigate the effect of sleep quality on depression among the community-dwelling elderly and analyze the mediating effect of perceived stress between them.Methods　From May 2015 to July 2015,older adults were enrolled from community in Shenyang（Heping district,Tiexi district and Huanggu district）,Dalian（Shahekou district,Ganjingzi district and Xigang district）,Jinzhou（Linghe district,Guta district and Taihe district） of Liaoning Province by convenience sampling method.Survey stations were located in the places where older people often held activities,such as parks,squares,and community health service centers.The demographic questionnaire,Pittsburg Sleep Quality Index Scale（PSQI）,Chinese version Perceived Stress Scale（CPSS） and the Center for Epidemiologic Studies Depression Scale（CES-D） were used to evaluate the general demographic characteristics,sleep quality,perceived stress and depression.Pearson correlation analysis was conducted on the relation among sleep quality,perceived stress and depression,and the mediating effect of perceived stress between sleep quality and depression was analyzed by SPSS 21.0 and AMOS 22.0.Results　A total of 1 050 questionnaires were distributed,the number of valid questionnaires were 1 032,valid recovery rate was 98.3%.The scores of PSQI,CPSS and CES-D were（5.5±2.9）,（25.2±8.1） and（12.6±8.9） respectively.There was positive correlation between the score of CES-D and the score of PSQI and CPSS（r=0.63,0.42;P<0.01）,and there was positive correlation between the score of CPSS and the score of PSQI（r=0.36,P<0.01）.The results of simple linear regression showed that there was a linear regression relationship between sleep quality and depression（β=0.460,SE=0.028,t=16.605,P<0.001） and perceived stress（β=0.627,SE=0.024,t=25.856,P<0.001）.The results of multiple linear regression showed that there was linear regression relationship between sleep quality（β=0.277,SE=0.034,t=8.053,P<0.001）,perceived stress（β=0.291,SE=0.034,t=8.471,P<0.001） and depression.The mediating effect test results showed the following investigation data:χ2/df=4.713,NFI=0.926,RFI=0.907,IFI=0.941,TLI=0.925,CFI=0.940,GFI=0.956,RMSEA=0.060.The Bootstrap test results showed 95% CI of the direct and indirect effect of sleep quality on depression excluded 0,the relationship between sleep quality and depression was partly mediated by perceived stress,the value of mediating effect was 0.129,and the proportion of mediation was 62.6%（0.129/0.206）.Conclusion　Sleep quality plays an indirect effect on depression by the mediating effect of perceived stress among the community-dwelling elderly;perceived stress plays a part mediating effect between sleep quality and depression.

Key words: Sleep, Depression, Aged, Perceived stress

摘要： 目的　探究睡眠质量对城市社区老年人抑郁的影响，考察觉知压力在二者关系间的中介作用。方法　采用方便抽样法，于2015年5—7月对辽宁省沈阳市（和平区、铁西区和皇姑区）、大连市（沙河口区、甘井子区和西岗区）和锦州市（凌河区、古塔区和太和区）的社区老年人为调查对象，调查点设在公园、广场、社区服务中心等老年人经常活动的地方。分别采用一般人口学资料问卷、匹兹堡睡眠质量指数量表、觉知压力量表、流调中心抑郁量表调查其一般人口学资料、睡眠质量、觉知压力及抑郁情况。采用SPSS 21.0和AMOS 22.0软件对睡眠质量、觉知压力与抑郁三者之间关系进行Pearson相关分析和中介效应分析。结果　共发放问卷1 050份，回收有效问卷1 032份，有效回收率为98.3%。睡眠质量得分为（5.5±2.9）分，觉知压力得分为（25.2±8.1）分，抑郁得分为（12.6±8.9）分。睡眠质量得分与觉知压力、抑郁得分均呈正相关（r=0.63、0.42，P<0.01）；觉知压力得分与抑郁得分呈正相关（r=0.36，P<0.01）。简单线性回归分析结果显示，睡眠质量与抑郁有线性回归关系（β=0.460，SE=0.028，t=16.605，P<0.001）；睡眠质量与觉知压力有线性回归关系（β=0.627，SE=0.024，t=25.856，P<0.001）。多元线性回归分析结果显示，睡眠质量、觉知压力与抑郁均有线性回归关系（睡眠质量：β=0.277，SE=0.034，t=8.053，P<0.001；觉知压力：β=0.291，SE=0.034，t=8.471，P<0.001）。中介效应验证结果显示，χ2/df=4.713，规范拟合指数=0.926，相对拟合指数=0.907，增量拟合指数=0.941，非规范拟合指数=0.925，比较拟合指数=0.940，拟合优度指数=0.956，近似误差均方根=0.060。Bootstrap法检验结果显示，睡眠质量到抑郁直接效应、间接效应的95%CI均未包含0，综合说明觉知压力的部分中介效应模型成立，且部分中介效应为0.129，占总效应的62.6%（0.129/0.206）。结论　睡眠质量主要通过觉知压力的中介作用对老年人抑郁产生间接效应，且觉知压力在睡眠质量与抑郁间起部分中介作用。

关键词: 睡眠, 抑郁, 老年人, 觉知压力