Self-neglect as a mediator between family functioning and healthy aging in older adults living alone in rural China: A cross-sectional study

•This cross sectional study aimed to explore the relationships between family functioning, self-neglect, and healthy aging among older adults living alone in rural China.•The findings revealed a significant positive association between family functioning and healthy aging, underscoring the crucial role of family support in promoting health during later life stages.•The findings identified the mediating role of self-neglect in this relationship, with the mediating effect accounting for 40.84 % of the total impact. This study aims to investigate the mediating role of self-neglect among older adults in the relationship between family functioning and healthy aging. A questionnaire survey was conducted between June and September 2023, involving 255 older adults living alone in rural China. The healthy ageing, self-neglect, and family functioning was assessed using the Healthy Aging Instrument;the Elderly Self-neglect Assessment (Rural);and Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) scale. Positive correlations were found between family functioning and healthy aging (r = 0.363, p < 0.05). Moreover, self-neglect was identified as a significant mediator, explaining 40.84 % of the total effect. Among older adults living alone in rural China, family functioning is significantly associated with healthy aging, with self-neglect mediating this relationship. These findings suggest that community-based interventions aimed at improving family functioning and addressing self-neglect behaviors might be beneficial for promoting healthy aging in this population.