Objective: To investigate the mediating role of activities of daily living (ADL) and self-rated health in chronic disease-caused depressive symptoms among the elderly, so as to provide insights into depression control among the elderly. Methods: Basic features, depressive symptoms, number of chronic diseases, ADL and self-rated health of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2018. Multiple linear regression model was created using the Process program to examine the mediating role of ADL and self-rated health in number of chronic disease-caused depressive symptoms, and the significance of the mediating role was tested using the Bootstrap test. Results: A total of 5 892 elderly participants were enrolled, with a mean age of (68.42±6.23) years and including 2 744 men (46.57%). The participants had a median depressive symptom score of 8 (interquartile range, 10) points, a median number of chronic diseases of 1 (interquartile range, 1), a median ADL score of 12 (interquartile range, 3) points, and a median self-rated health score of 3 (interquartile range, 1) points. Mediation analysis showed that number of chronic diseases affected depressive symptoms via the independent mediating role of ADL (β=0.163, 95%CI: 0.120-0.206) and self-rated health (β=0.303, 95%CI: 0.259-0.351), and affected depressive symptoms via the chain mediating role of ADL and self-rated health (β=0.057, 95%CI: 0.043-0.074) among the elderly, and the gross mediating role consisted of 58.44% of total effects. Conclusions The number of chronic diseases may incease the risk of depressive symptoms through aggravating the impairment of ADL and decreasing self-rated health levels among the elderly.

Objective: To investigate the willingness to pay integrated medical and elderly care services and identify the influencing factors among the elderly in Hohhot City, Inner Mongolia, so as to provide insights into promoting integrated medical and elderly care services. Methods: The elderly at ages of 60 years and older were sampled using a convenient sampling method from public venues in four districts of Huimin, Saihan, Yuquan and Xincheng in Hohhot City from June to December 2021. Basic characteristics, health and disease burdens, social support and willingness to pay integrated medical and elderly care services were collected, and factors affecting the willingness to pay integrated medical and elderly care services were identified among the elderly using a multiple linear regression model. Results: A total of 1 008 valid questionnaires were recovered, with an effective recovery rate of 96.74%. The respondents included 519 men (51.49%) and 489 women (48.51%), and had a mean age of (69.47±6.42) years. The monthly average fees of willingness to pay integrated medical and elderly care services were (2 076.49±36.79) Yuan, and there were 636 participants with 2 000 Yuan and less monthly average fees of willingness to pay integrated medical and elderly care services (63.10%). Multiple linear regression analysis showed that place of residence (β=180.832), satisfaction with housing (satisfied, β=-140.760), physical self-care ability (completely self-care: β=-238.244; mostly self-care: β=-254.557), burdens of disease diagnosis and treatment (able to afford: β=452.488; partly afford: β=228.626), monthly income (β=347.144), expenses of medications (β=0.019) and total score of social support (β=17.116) were factors affecting the willingness to pay integrated medical and elderly care services among the elderly. Conclusions The willingness to pay integrated medical and elderly care services among the elderly in Hohhot City is associated with place of residence, monthly income, satisfaction with housing, physical self-care ability, burden of disease diagnosis and treatment, expenses of medications and social support.