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Background <p>Disabled older adults tend to get trapped in a health downward spiral, posing a challenging to health equity. This study captured the healthy ageing pathway from health capacity and environment to health function, aimed to explore the health function disparities and investigate the root causes from capacity-environment perspectives, and propose the disability-specific and function-specific pathways.</p> Methods <p>A multi-stage stratified random sampling was employed to select a total of 2688 Chinese older adults, among which 451 were disabled older adults (≥ 60 years). Linear regressions were used to examine the group differences in health function, capacity and environments. Structural equation models (SEM) were adopted to structure and compare the healthy ageing pathways between groups and functions.</p> Results <p>Disabled older adults reported significant lower scores across health functions, capacities, and environmental factors. A larger gap in health function was observed between groups. SEM captures a healthy ageing pathway as “health capacity→APGAR and age-friendly social environment→health function” among disabled older adults. The indirect effect (β = 0.276, <i>p</i> &lt; 0.001) of health capacity was approximately 3 times that of its direct effect (β = 0.090, <i>p</i> &lt; 0.001) on health function. The mediating role of environments was stronger in the disabled group. Compared with non-disabled group, a missing path through personal life expectation to health function was found. Regarding function-specific healthy ageing pathways, cognitive ability contributed to all health functions (<i>all</i> <i>p</i> &lt; 0.001). Age-friendly environments played critical mediating roles in all functions except psycho-emotional function. Among environments, life security environments showed a wide correlations with health functions.</p> Conclusions <p>This research showed a comprehensive health function deficit in the disabled older group, and claimed more focus on its root causes, especially on environmental factors. We suggested a coordinated design of self-capacity and environmental interventions, such as cognitive ability and life security environment interventions, to promote healthy ageing in disabled older adults.</p>

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How to promote healthy ageing among disabled older adults: from a group difference perspective and function-specific pathway models

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Jingjing Cai,
  • Minmin Jiang,
  • Lu Li

摘要

Background

Disabled older adults tend to get trapped in a health downward spiral, posing a challenging to health equity. This study captured the healthy ageing pathway from health capacity and environment to health function, aimed to explore the health function disparities and investigate the root causes from capacity-environment perspectives, and propose the disability-specific and function-specific pathways.

Methods

A multi-stage stratified random sampling was employed to select a total of 2688 Chinese older adults, among which 451 were disabled older adults (≥ 60 years). Linear regressions were used to examine the group differences in health function, capacity and environments. Structural equation models (SEM) were adopted to structure and compare the healthy ageing pathways between groups and functions.

Results

Disabled older adults reported significant lower scores across health functions, capacities, and environmental factors. A larger gap in health function was observed between groups. SEM captures a healthy ageing pathway as “health capacity→APGAR and age-friendly social environment→health function” among disabled older adults. The indirect effect (β = 0.276, p < 0.001) of health capacity was approximately 3 times that of its direct effect (β = 0.090, p < 0.001) on health function. The mediating role of environments was stronger in the disabled group. Compared with non-disabled group, a missing path through personal life expectation to health function was found. Regarding function-specific healthy ageing pathways, cognitive ability contributed to all health functions (all p < 0.001). Age-friendly environments played critical mediating roles in all functions except psycho-emotional function. Among environments, life security environments showed a wide correlations with health functions.

Conclusions

This research showed a comprehensive health function deficit in the disabled older group, and claimed more focus on its root causes, especially on environmental factors. We suggested a coordinated design of self-capacity and environmental interventions, such as cognitive ability and life security environment interventions, to promote healthy ageing in disabled older adults.