To explore the mediating roles of self-care ability and self-rated health between physical inactivity and depressive symptoms among elderly individuals.

Data from 8 279 participants (≥60 years) in the 2020 CHARLS database were analyzed using correlation and regression to explore the relationship between physical inactivity, self-care ability, self-rated health and depressive symptoms. The chain mediating effect model was used to analyze the multiple mediating effects.

Depressive symptoms prevalence was 40.89% among people aged 60 and above. Physical inactivity (β=0.402, P<0.01), self-care ability (β=-0.186, P<0.001) and self-rated health (β=-1.724, P<0.001) directly predicted depressive symptoms. The simple mediation effects were 0.142 for self-care ability and 0.072 for self-rated health between physical inactivity and depressive symptoms, with a chain mediation effect of 0.056.

Self-care ability and self-rated health have a direct mediating effect and a chain mediating effect between physical inactivity and depressive symptoms in the elderly. Enhancing physical activity may improve body functional capacity, self-care ability and health, thereby reducing depressive symptoms risk.