AccScience Publishing / HPR / Online First / DOI: 10.36922/HPR026240129
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RESEARCH ARTICLE

Perceived fatigability and health-related quality of life among community-dwelling older adults in Nanjing, China

Fei Xu1,2 ,  Qing Ye1 ,  Zhiyong Wang1,2 ,  Caihong Hu2 ,  Guofeng Ao1,2 ,  Luyan Yang1,2 ,  Ying Ji1,2 ,  Nancy W. Glynn3 ,  Hongyang Liu4* ,  Zhenglin Wang5* ,  Daowen Chen4
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1 Nanjing Municipal Center for Disease Control and Prevention, Nanjing , China
2 Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing , China
3 Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania , United States of America
4 Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing , China
5 Geriatric Hospital of Nanjing Medical University, Nanjing , China
HPR, 026240129 https://doi.org/10.36922/HPR026240129
Received: 14 June 2026 | Revised: 22 August 2026 | Accepted: 2 September 2026 | Published online: 17 September 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Fatigability is prevalent among older adults and affects quality of life. It has become a public health concern in the current era of rapid population aging. China has the world’s largest older population. However, no study has addressed this issue in China.

Objective: This study examined the associations of physical and mental fatigability with physical and mental measures of health-related quality of life (HRQoL), respectively, among community-dwelling older adults in regional China.

Methods: We collected cross-sectional data from residents aged 60 years or older in Nanjing municipality, China, in 2023. We assessed physical and mental fatigability using the 10-item Pittsburgh Fatigability Scale and treated them as categorical variables. We assessed the physical and mental component summaries (physical component summary [PCS] and mental component summary [MCS], respectively) of HRQoL using the SF-12 and treated them as continuous outcome measures. We used mixed-effects linear regression to estimate the mean difference (MD) and 95% confidence interval (CI) in HRQoL PCS and MCS between participants with “less severe” and “more severe” fatigability.

Results: Among the 5,484 participants, the mean values ± standard deviations of HRQoL PCS and MCS scores were 52.14 ± 8.87 and 36.66 ± 7.09, respectively. Overall, after full adjustment for potential confounders, higher physical (MD = −1.63, 95% CI: −2.05 to −1.20) and mental (MD = −1.67, 95% CI: −2.09 to −1.25) fatigability were both associated with poorer HRQoL PCS. Neither physical nor mental fatigability was associated with HRQoL MCS (physical fatigability: MD = −0.06, 95% CI: −0.44 to 0.32; mental fatigability: MD = 0.29, 95% CI: −0.09 to 0.67). Moreover, the associations between fatigability and HRQoL among participants stratified by age or sex were broadly similar to those observed among all participants.

Conclusion: This study has public health implications for building a healthy-aging society, suggesting that fatigability may serve as a useful marker for identifying community-dwelling older adults with poorer physical HRQoL in regional China.

Keywords
Aging
Fatigue
Health-related quality of life
SF-12
Pittsburgh Fatigability Scale
Older adults
Funding
This study was supported by the Nanjing Medical Science and Technology Development Fund (ZKX24059; Recipient: FX).
Conflict of interest
The authors declare no competing interests.
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