Objective To understand the disability index and its influencing factors among Chinese older adults from 2011 to 2018 and provide a reference for the development and adjustment of disability prevention policies.

Methods We collected the data related to the disability index of 17 928 older adults aged 60 years and above in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. We conducted the Mann-Kendall trend test to analyze the trend of disability index in Chinese older adults from 2011 to 2018 and adopted the generalized estimating equation (GEE) to analyze its influencing factors.

Results The median score of disability index was 29.17 (15.28, 44.17) among 17 928 older adults aged 60 years and above in China. The median scores of disability index in 2011, 2013, 2015, and 2018 were 28.89 (13.89, 44.44), 26.94 (14.44, 41.11), 27.22 (13.89, 43.68), and 32.22 (22.78, 46.11), respectively. From 2011 to 2018, the disability index of older adults first improved and then worsened (τ_b = 0.066, P < 0.001). The results of the GEE analysis showed that the disability index was higher among Chinese older adults with a survey time point of 2018, being female, aged ≥ 75 years, in central or western China, residing in rural areas, having no medical insurance, suffering from ≥ 1 chronic disease, and having a history of falls. Chinese older adults with a survey time point of 2013 or 2015, having a primary school education or above, being married, and having a self-rated memory as fair or good had a lower disability index.

Conclusions The disability index of Chinese older adults showed a trend of first improvement and then deterioration from 2011 to 2018. The survey time point, gender, age, education background, marital status, region, residence place, medical insurance, chronic disease, history of falls, and self-rated memory were the main influencing factors of the disability index in Chinese older adults.