Longitudinal Associations Between Neighborhood Social Cohesion and Sleep Disturbance Among Older Adults: The Mediating Role of Depressive Symptoms

Sleep disturbance is highly prevalent in later life and often co-occurs with depressive symptoms.
However, the social and psychological factors that contribute to its development remain poorly
understood. This longitudinal study examined whether perceived neighborhood social cohesion was
associated with subsequent sleep disturbance and whether depressive symptoms mediated this
association among older adults. Data were drawn from five waves (2006, 2010, 2014, 2018, and 2022) of
the psychosocial subsample of the Health and Retirement Study. The analytic sample comprised 3,360
respondents aged 50 years or older. Univariate and parallel process latent growth curve models were
used to examine the developmental trajectory patterns and their associations. A latent growth curve
mediation model was further utilized to test the indirect pathways at both the intercept and slope levels.
At the intercept level, higher neighborhood social cohesion in 2006 was associated with lower levels of
depressive symptoms and sleep disturbance in 2010. The indirect association via depressive symptoms
was significant (B = − 0.311, 95% CI [− 0.383, − 0.239]). At the slope level, greater declines in cohesion
were associated with greater increases in depressive symptoms (B = − 0.351, 95% CI [− 0.676, − 0.026]),
and the indirect path on change in sleep disturbance was also significant (B = − 0.332, 95% CI [− 0.651, − 
0.014]). Depressive symptoms may represent an important pathway linking neighborhood social
cohesion to sleep disturbance among older adults, highlighting the potential value of strengthening
social cohesion and addressing depressive symptoms to promote sleep health.