Background As globally prevalent mental health conditions, anxiety and depression impose significant socioeconomic burdens on healthcare systems. Key risk factors for anxiety and depression were determined in the current study by examining the associations across multiple domains. Methods Participants were enrolled for this cross-sectional study from the Department of Gerontology at the Fifth Affiliated Hospital of Sun Yat-sen University in 2023. Anxiety and depression were evaluated based on the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAMD) Rating Scales, respectively. Cognitive function, sleep quality, frailty, and nutritional status were evaluated using the Montreal Cognitive Assessment (MoCA), the Pittsburgh Sleep Quality Index (PSQI), the FRAIL scale, and the Nutrition Risk Screening (NRS)-2002, respectively. Multiple linear regression analysis was performed to determine the factors associated with anxiety and depression. Results A total of 1121 participants (659 women and 462 men; mean age ± SD: 64.67 ± 10.86 years) were studied. HAMD scores were significantly associated with gender (β = 0.078, P = 0.017), body mass index (β = -0.096, P = 0.003), MoCA (β = -0.141, P 0.001), FRAIL score (β = 0.200, P 0.001), PSQI (β = 0.494, P 0.001), and NRS-2002 (β = 0.099, P = 0.004) after full adjustment. HAM-A scores exhibited significant and independent associations with gender (β = 0.155, P 0.001), illness (β = -0.098, P = 0.006), MoCA (β = -0.114, P = 0.001), PSQI (β = 0.435, P 0.001), and FRAIL score (β = 0.276, P 0.001). Conclusions Male patients with superior physical and cognitive function, better sleep, favorable body mass index and nutrition status, and fewer illnesses had better mood. Targeted interventions, including cognitive preservation, sleep optimization, frailty prevention, comorbidity management, and lifestyle modification, may be correlated with reduced symptom burden. Special consideration is warranted for elderly and female populations.
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