Evidence map›Paper›PMID 42459485›Full record

ArticleFrontiers in public health2026

The relationship between disability and quality of life among older adults: the roles of sleep, depression, and living arrangements.

Jing Zhu, Zhiqiang Feng, Zhongming Chen, Lin Guo, Chengxin Fan, Chunxiao Yang, Zixuan Zhao, Xingang Sang, Lingzhong Xu, Wenqiang Yin

Abstract read
In one paragraph

Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jing ZhuSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
Zhiqiang Feng"Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, Weifang, Shandong, China.
Zhongming Chen"Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, Weifang, Shandong, China.
Lin Guo"Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, Weifang, Shandong, China.
Chengxin FanSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
Chunxiao YangSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
Zixuan ZhaoSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
Xingang SangWeifang Municipal Health Commission, Weifang, China.
Lingzhong XuCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Wenqiang Yin"Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, Weifang, Shandong, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The acceleration of population aging, especially in China, has led to a rapid growth in the number of older adults living with disabilities, posing significant challenges to public health and quality of life (QoL). From the perspective of the biopsychosocial framework, the adverse impact of disability (a biological and functional factor) on QoL has been well documented. However, the underlying mechanisms linking disability to QoL within this framework, especially the mediating roles of psychological factors (e.g., depression) and physiological correlates (e.g., sleep quality), remain insufficiently understood. Furthermore, living arrangements, as a key social factor in the biopsychosocial model, may moderate these mediating pathways. Therefore, this study aimed to examine the mediating roles of sleep quality and depression in the association between disability and QoL and to explore whether living arrangements moderate these pathways within the biopsychosocial framework. Methods: A total of 3,855 adults aged ≥60 years were recruited through the Household Health Interview Survey in Taian City, China, using a multi-stage stratified cluster sampling method. Data were collected on disability [measured using the Physical Self-Maintenance Scale (PSMS)], sleep quality [assessed using the Pittsburgh Sleep Quality Index (PSQI)], depression [assessed using the Patient Health Questionnaire-9 (PHQ-9)], living arrangements, QoL (assessed using the EQ-5D-5L), and relevant covariates. Statistical analyses included descriptive analysis, logistic regression, and moderated mediation analysis using the PROCESS macro. Results: Disability was significantly associated with poorer QoL (OR = 1.816-1.928, Conclusion: Disability was associated with poorer QoL among older adults, and this relationship was partially explained by sleep quality and depression, with living arrangements further moderating the pathways linking disability to sleep quality and depression. These findings highlight the importance of integrated interventions that address physical, psychological, and social factors to improve QoL among older adults with disabilities. Targeted strategies, including sleep management, depression screening, and enhanced social support, particularly for those living alone, may help improve QoL and promote healthy aging.

Indexed as

DepressionPersons with DisabilitiesQuality of LifeResidence CharacteristicsSleep QualityAgedAged, 80 and overChinaFemaleHumansMaleMiddle Ageddepressiondisabilityliving arrangementolder adultspublic healthquality of lifesleep quality

Identifiers

PMID42459485
PMCPMC13368539

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.