Abstract
BACKGROUND: With the acceleration of population aging, the problem of obesity among older adults is becoming increasingly prominent, representing a major public health problem affecting the health of older adults. In recent years, socioeconomic status(SES) has become a hotspot in research into the mechanisms influencing obesity(OB). However, few studies have explored the process and mechanism of action by which SES affects obesity. METHODS: The sample consisted of 5,576 older adults (≥ 65 years), from a large cross-sectional study conducted in Deyang City, China. Different factors associated with OB in older adults were assessed using χ2 test. Pearson correlation analysis and the SPSS function "PROCESS macro" were used for correlation and serial multiple mediation analysis, respectively, to analyze the relationship between SES and OB, and the mediating role of social support and sleep quality. RESULTS: The prevalence of obesity among older adults aged ≥ 65 years was 11.05%. The risk of obesity was higher among older adults who were women, relatively young, less educated, non-smokers, or with chronic diseases. SES directly affects obesity (SE = 0.187, 95% CI: 0.105, 0.270), accounting for 88.21% of the total effect. Additionally, social support and sleep quality were found to mitigate the negative effect of high SES on obesity (SE = - 0.025, 95% CI: - 0.045, - 0.006), resulting in a suppressing effect that accounts for 11.79% of the total effect. CONCLUSIONS: Greater social support and sleep quality lower the obesity risk associated with SES in older adults. Therefore, targeted prevention, control, and intervention measures, such as increasing social support and improving sleep quality, can be applied based on the characteristics of older adults of different socioeconomic statuses to minimize the socioeconomic status-associated obesity risks and thus achieve the goal of reducing obesity.