Abstract
Background: Poor sleep quality is common in older adults and closely tied to emotional well-being. While life satisfaction has been linked to sleep outcomes, the psychological pathways remain underexplored. Purpose: This study examines whether psychological resilience and anxiety symptoms mediate the relationship between life satisfaction and sleep quality among older adults, and whether chronic disease moderates these pathways. Methods: Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, including 3089 community-dwelling adults aged 65 years and older. Sleep quality and life satisfaction were measured using validated single-item indicators. Psychological resilience was assessed using five self-reported items capturing adaptive functioning, and anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder Scale. A parallel mediation model and a moderated mediation model were tested using SPSS with bootstrapping procedures (5000 samples). Results: Life satisfaction was significantly associated with sleep quality among older adults. This association was partially mediated by both psychological resilience (indirect association = -0.0100, 95% CI [-0.0163, -0.0045]) and anxiety symptoms (indirect association = -0.0356, 95% CI [-0.0483, -0.0238]). The direct association remained significant (β = -0.2399, p < 0.001), indicating a partial mediation pattern. Furthermore, in the moderated mediation model, chronic disease moderated the association between anxiety symptoms and sleep quality, whereas the indices of moderated mediation were not significant. Conclusions: Life satisfaction was associated with sleep quality, with psychological resilience and anxiety symptoms accounting for part of this association. Although chronic disease strengthened the association between anxiety symptoms and poorer sleep quality, the overall moderated mediation effect was not significant.