Socioeconomic Status and Depression Among Low-Education Disabled Oldest-Old in China: A Serial Multiple Mediation Analysis

Depression reduces the quality of life of older adults with disabilities, adversely impacting the healthy aging of the global population. This study examined whether social participation and self-rated health play a chain mediating role between socioeconomic status and depressive symptoms in elderly people with disabilities. The data were derived from the Chinese Longitudinal Healthy Longevity Survey (n = 1,354). Results indicate that total family income had a direct impact on depressive symptoms (β = -0.220, 95%CI: -0.417, -0.022) and an indirect impact through social participation (β = -0.040, 95%CI: -0.081, -0.009) and self-rated health (β = -0.149, 95%CI: -0.246, -0.055), with a significant serial mediation effect (β = -0.022, 95%CI: -0.040, -0.007). Policies should prioritize integrated delivery of economic support, social-participation facilitation, health security, and comprehensive services to provide targeted assistance to low-education disabled oldest-old adults, and should actively foster their sustained societal engagement through community-based, barrier-free, and low-tempo activity designs.