{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T21:10:13Z","timestamp":1789852213496,"version":"4.0.1"},"reference-count":52,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    This study used longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS;\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 7,900, aged \u226560) to examine the mechanisms linking the number of chronic diseases with health-related quality of life (HRQoL) in older Chinese adults. Chronic diseases were significantly associated with reduced HRQoL (\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    <jats:sub>total<\/jats:sub>\n                    = \u22120.01, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : \u22120.011, \u22120.009). Disability and depressive symptoms jointly mediated 69% of this effect through independent (\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    <jats:sub>disability<\/jats:sub>\n                    = \u22120.0027, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : \u22120.0031, \u22120.0022;\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    <jats:sub>depressive<\/jats:sub>\n                    = \u22120.0034, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : \u22120.0039, \u22120.003) and chain mediation (\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    <jats:sub>disability-depressive<\/jats:sub>\n                    = \u22120.0008, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : \u22120.0009, \u22120.0006). Notably, informal social support moderated this negative relationship (\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    = 0.002, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : 0.001, 0.003), while formal social support had no significant impact (\n                    <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                    = \u22120.0002, 95%\n                    <jats:italic toggle=\"yes\">CI<\/jats:italic>\n                    : \u22120.001, 0.002). This study highlighted the need for interventions targeting management of disability and depressive symptoms, while leveraging informal care networks to mitigate HRQoL decline in the elderly.\n                  <\/jats:p>","DOI":"10.1177\/07334648251390014","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T16:26:52Z","timestamp":1762964812000},"page":"1788-1796","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanisms Linking the Number of Chronic Diseases to Health-Related Quality of Life in Older Adults: The Roles of Disability, Depressive Symptoms, and Social Support"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0306-5516","authenticated-orcid":false,"given":"Chao-Nan","family":"Chen","sequence":"first","affiliation":[{"name":"School of Government, Beijing Normal University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Yun","family":"Liang","sequence":"additional","affiliation":[{"name":"School of Government, Beijing Normal University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"issue":"5","key":"e_1_3_7_2_1","first-page":"155","article-title":"Status quo of treatment adherence and its influential factors in community management of patients with chronic diseases in nanjing","volume":"35","author":"An J. 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