Abstract: Objective: To investigate the status quo of cognitive function, depressive state, and physical functions of older adults living in self-care area of nursing homes, and to explore the pathway among these three variables, providing evidence for developing targeted care plans. Methods: A cross-sectional survey was conducted among 232 older adults in the self-care area of 4 nursing homes in Xiangtan city, Hunan province, using convenience sampling from July to August 2024 and September 2025. The general information questionnaire, Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire-9 (PHQ-9), and Short Physical Performance Battery (SPPB) were used for data collection. Structural equation modeling was performed to examine the pathways among cognitive function, physical function and depression. Results: The cognitive function score was 23.00±5.19, with 150 participants (64.6%) potentially having cognitive impairment. The depression score was 1.00 (0, 3.00), and 30 participants (12.9%) were indicated to potentially have depression. The physical function score was 7.77±3.84, and 135 participants (58.2%) had impaired physical function. The structural equation model showed a good fit (RMSEA=0.074, CFI=0.892). Path analysis revealed that cognitive function had a significant direct positive effect on physical function (β=0.360, P<0.001), and depressive state had a significant direct negative effect on physical function (β=-0.255, P<0.001). The mediating effect test indicated that depressive state played a partial mediating role (β=0.035, 95%CI: 0.001-0.097). Conclusion: The functional status of older adults in the self-care area of nursing homes is not very good. Cognitive function affects physical function mainly through a direct pathway, with depressive state playing a partial mediating role. An integrated cognitive-emotional-physical care approach is recommended.

Key words: the aged; cognitive function; depressive; physical function; nursing home