Abstract: Paying attention to the physical and mental health of Chinese older adults is of great significance for promoting the implementation of the National Strategy for Actively Responding to Population Ageing and the Healthy China strategy. By applying the fixed effect model and cross-lagged panel model to the data of the China Health and Retirement Longitudinal Study (CHARLS) 2013, 2015, and 2018, this paper analyzes the causal relationship between physical disability and depressive symptoms among Chinese older adults. The results show that there is a significant positive correlation between physical disability and depressive symptoms during the same period. After controlling for unobserved confounding factors, the deterioration and improvement of physical disability will significantly affect changes in depressive symptoms. Using the cross-lagged panel model, we found a bidirectional causal relationship between physical disability and depressive symptoms among older adults. By utilizing three physical disability measurement indices, namely the Nagi Index, IADL Index, and ADL Index, it was discovered that the bidirectional causal relationship between them remains significant. Therefore, it is necessary to enhance the prevention and rehabilitation of physical disability among Chinese older adults and to construct a comprehensive health service system for older adults that encompasses various aspects, including physical and mental health.

Keywords: Physical Disability, Depressive Symptoms, Bidirectional Causal Relationship, Cross-Lagged Panel Model

摘要： 重视老年人身心健康，对于实施积极应对人口老龄化国家战略和健康中国战略具有重要意义。基于中国健康与养老追踪调查(CHARLS)2013年、2015年和2018年的个体层面追踪数据，利用固定效应模型和交叉滞后面板模型，对老年人失能程度与抑郁程度之间的因果关系进行量化考察。研究发现，失能程度与老年人当期的抑郁程度存在显著的正相关关系；控制未被观测到的混淆因素后，失能程度变化会显著影响抑郁程度变化；老年人失能程度与抑郁程度之间存在着双向因果关系，且无论使用Nagi指数、ADL指数还是IADL指数等指标来测量失能程度，二者之间的双向因果关系都显著。因此，应当加强老年人失能预防和失能康复工作，并构建覆盖身体健康与心理健康等多方面的综合性老年人健康服务体系。

关键词: 失能程度, 抑郁程度, 双向因果关系, 交叉滞后面板模型