Abstract
OBJECTIVE: This study examined the associations among mind-body exercise, emotion regulation, sleep quality, and anxiety in middle-aged and older adults, with particular attention to whether emotion regulation and sleep quality operate as sequential mediators linking mind-body exercise to anxiety. METHODS: A cross-sectional survey was conducted with 382 middle-aged and older adults who regularly participated in mind-body exercise. Mind-body exercise, emotion regulation, sleep quality, and anxiety were assessed using validated self-report scales, including the Physical Activity Rating Scale (PARS-3) Questionnaire, the Emotion Regulation Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the GAD-7. Data analyses were performed using SPSS 26.0 for descriptive statistics and correlations, and AMOS 24.0 for structural equation modeling to test the mediation and chain mediation pathways. RESULTS: Mind-body exercise was significantly and negatively associated with anxiety (p < 0.01). Both emotion regulation and sleep quality served as significant mediators of this relationship. In addition, a sequential mediation pathway linking mind-body exercise, emotion regulation, sleep quality, and anxiety was supported, indicating that better emotion regulation was associated with improved sleep quality, which in turn was related to lower anxiety levels. CONCLUSION: These findings suggest that emotion regulation and sleep quality jointly help explain how mind-body exercise relates to anxiety in middle-aged and older adults. The results provide insight into the interconnected psychological processes linked with mind-body practices and highlight their potential value as non-pharmacological options for anxiety management in aging populations.