Associations of 24-hour movement behaviors with depressive symptoms in rural-dwelling older adults: a compositional data analysis

Background We aimed to explore the association of sleep duration with depressive symptoms among rural-dwelling older adults in China, and to estimate the impact of substituting sleep with sedentary behavior (SB) and physical activity (PA) on the association with depressive symptoms. Methods This population-based cross-sectional study included 2001 rural-dwelling older adults (age ≥ 60 years, 59.2% female). Sleep duration was assessed using the Pittsburgh Sleep Quality Index. We used accelerometers to assess SB and PA, and the 15-item Geriatric Depression Scale to assess depressive symptoms. Data were analyzed using restricted cubic splines, compositional logistic regression, and isotemporal substitution models. Results Restricted cubic spline curves showed a U-shaped association between daily sleep duration and the likelihood of depressive symptoms ( P -nonlinear