Diabetes and depression are global public health issues. There is a significant correlation between diabetes and depression. Therefore, monitoring and intervening in diabetes, depression, and their comorbidity among middle-aged and elderly people is crucial.

To explores the prevalence of diabetes and depression, as well as their comorbidity, among the elderly population, and the impact of sleep, exercise, and social activities on these conditions.

Based on the 2018 China Health and Retirement Longitudinal Study, 11 177 participants who met the research criteria were included as subjects. A multifactorial Logistic regression analysis model was employed to investigate the association between sleep, exercise, and social activities with the comorbidity of diabetes and depression. Subsequently, the product of nap duration and nighttime sleep duration was incorporated into the regression model for interaction analysis.

A total of 11 177 subjects were included in the study, with a prevalence of diabetes of 13.95% (1 559/11 177), a prevalence of depressive status of 24.85% (2 777/11 177), and a comorbidity prevalence of both diabetes and depressive status of 14.64% (1 636/11 177). The results of the multinomial Logistic regression analysis indicated that a nighttime sleep duration of 7 to 9 hours (OR=0.337, 95%CI=0.296-0.384), a nighttime sleep duration greater than 9 hours (OR=0.509, 95%CI=0.374-0.692), and a nap duration greater than 90 minutes (OR=0.792, 95%CI=0.666-0.941) were all protective factors for the comorbidity of diabetes and depressive status. High levels of social interaction were also found to reduce the risk of comorbidity (OR=0.778, 95%CI=0.686-0.882, P<0.05). The interaction analysis results showed that maintaining a nighttime sleep duration of 7 to 9 hours, regardless of nap duration, was effective in preventing the comorbidity of diabetes and depressive status (P<0.001). If the nighttime sleep duration is less than 7 hours, a nap duration of 60 to 90 minutes can also reduce the risk of comorbidity (OR=0.740, 95%CI=0.577-0.950, P<0.05). In the case of a nighttime sleep duration greater than 9 hours, not taking a nap (OR=0.270, 95%CI=0.125-0.581) or maintaining a nap duration of 60 to 90 minutes (OR=0.165, 95%CI=0.040-0.674) can also reduce the risk of comorbidity.

The comorbidity prevalence of diabetes and depressive status among middle-aged and elderly people in China is relatively high (14.64%). Nighttime sleep duration of more than 7 hours, nap duration of more than 90 minutes, and a high level of social interaction can all effectively reduce the risk of comorbidity of diabetes and depressive status. Moderate levels of physical activity can reduce the risks of diabetes and depressive status respectively. Napping serves as a compensatory mechanism, helping to make up for insufficient nighttime sleep. If nighttime sleep is less than 7 hours, controlling the nap duration to 60 to 90 minutes can also reduce the risk of comorbidity of diabetes and depressive status.

糖尿病和抑郁症是全球性公共卫生问题。糖尿病与抑郁症显著相关，因此对中老年人糖尿病、抑郁及糖尿病和抑郁共病进行监测和干预至关重要。

探究中老年人糖尿病、抑郁状态及其共病患病率，以及睡眠、运动和社交活动对其的影响。

基于2018年中国健康与养老追踪调查项目，纳入≥45岁中老年人为研究对象。收集其一般资料和糖尿病、抑郁状态患病情况及睡眠时长、运动、社交活动情况。采用多因素Logistic回归分析模型研究睡眠、运动和社交活动与糖尿病和抑郁状态共病之间的关联，将午睡时长和夜间睡眠时长的乘积纳入回归模型中进行交互作用分析。

共纳入11 177名为研究对象，其中糖尿病患病率为13.95%（1 559/11 177），抑郁状态患病率为24.85%（2 777/11 177），糖尿病和抑郁状态共病患病率为14.64%（1 636/11 177）。多元无序Logistic回归结果显示，夜间睡眠时长7~9 h（OR=0.337，95%CI=0.296~0.384）、夜间睡眠时长>9 h（OR=0.509，95%CI=0.374~0.692）以及午睡时长≥90 min（OR=0.792，95%CI=0.666~0.941）均是糖尿病和抑郁状态共病的保护因素（P<0.05）；高水平社交同样能降低患共病的风险（OR=0.778，95%CI=0.686~0.882，P<0.05）。交互作用分析结果显示，保持7~9 h夜间睡眠时长，无论午休时间长短，均能有效降低糖尿病和抑郁状态共病患病风险（P<0.001）；若夜间睡眠时长<7 h，午睡时长为60~<90 min能降低共病患病风险（OR=0.740，95%CI=0.577~0.950，P<0.05）；在夜间睡眠时长>9 h，不午睡（OR=0.270，95%CI=0.125~0.581）或者保持60~<90 min的午睡时长（OR=0.165，95%CI=0.040~0.674）同样能够降低共病患病风险（P<0.05）。

我国中老年人糖尿病和抑郁状态共病患病率较高，夜间睡眠时长≥7 h、午睡时长≥90 min以及高水平社交能有效降低糖尿病和抑郁状态共病患病风险，中等水平体力活动可分别降低糖尿病和抑郁状态患病风险。午睡则作为一种补偿机制，有助于弥补夜间睡眠不足，若夜间睡眠时长<7 h，午睡时长控制在60~<90 min同样能够降低糖尿病和抑郁状态共病患病风险。