Disability influences physical and mental health of older people, and causes a heavy burden on family and society. The increasing prevalence of empty-nested phenomenon has aroused wide concern for empty and non-empty nesters.

To investigate the prevalence and associated factors of comprehensive disability in empty and non-empty nesters in Henan, providing a scientific basis for the prevention and control of disability among these people.

By use of multistage stratified sampling, 5 570 older people aged ≥60 years were selected from Henan's 18 provincial cities from January to September 2019 for a questionnaire survey. The comprehensive ability of them was assessed by using the Ability Assessment for Older Adults Scale developed by the Ministry of Civil Affairs of the People's Republic of China. Binary Logistic stepwise regression analysis was used to identify the factors associated with comprehensive disability.

The participants included 3 731 empty nesters and 1 839 non-empty nesters. The prevalence of intact comprehensive ability, and comprehensive disability in empty nesters was 51.97% (1 939/3 731) , and 48.03% 〔1 792 (1 417 mild, 217 moderate, and 104 severe) /3 731〕, respectively. The prevalence of intact comprehensive ability, and comprehensive disability in non-empty nesters was 44.64% (821/1 839) , and 55.36% 〔1 018 (820 mild, 123 moderate, and 75 severe) /1 839〕, respectively. Empty nesters had lower prevalence of comprehensive disability than did non-empty nesters (χ²=26.448, P<0.001) . Empty and non-empty nesters had significant differences in sex ratio, age distribution, marital status, education level, monthly income, financial support from children, prevalence of disability and accidents (P<0.05) . Stepwise binary Logistic regression analysis showed that age, prevalence of disability and accidents as well as number of chronic diseases were associated with comprehensive disability prevalence in both empty and non-empty nesters, and the specific corresponding data with values of OR and 95%CI were as follows: age 〔70-79 years, OR=1.590, 95%CI (1.373, 1.842) ; ≥80 years, OR=2.429, 95%CI (1.934, 3.050) 〕, disability 〔OR=3.803, 95%CI (2.924, 4.947) 〕, accidents 〔OR=2.747, 95%CI (2.101, 3.591) 〕, and number of chronic diseases 〔4-7, OR=6.549, 95%CI (3.736, 11.482) 〕were associated with comprehensive disability prevalence in empty nesters (P<0.05) . Age〔70-79 years, OR=1.357, 95%CI (1.084, 1.699) ; ≥80 years, OR=3.784, 95%CI (2.820, 5.076) 〕, disability〔OR=3.523, 95%CI (2.413, 5.145) 〕, accidents〔OR=2.789, 95%CI (1.962, 3.965) 〕 and number of chronic diseases 〔4-7, OR=2.997, 95%CI (1.460, 6.151) 〕 were associated with comprehensive disability prevalence in non-empty nesters (P<0.05) . In addition, comprehensive disability prevalence in empty nesters was also affected by education level 〔primary school: OR=0.748, 95%CI (0.629, 0.890) ; middle school: OR=0.776, 95%CI (0.634, 0.949) 〕, and financial support from children〔OR=1.318, 95%CI (1.146, 1.516) 〕 (P<0.05) . And comprehensive disability prevalence in non-empty nesters was also influenced by marital status 〔unmarried/divorced/widowed: OR=1.291, 95%CI (1.047, 1.592) 〕 and monthly income 〔1 001-2 000 yuan: OR=0.574, 95%CI (0.443, 0.743) 〕 (P<0.05) .

The associated factors of comprehensive disability prevalence for Henan's empty and non-empty nesters were not completely the same. Age, prevalence of disability, and accidents as well as number of chronic diseases were associated with comprehensive disability in both of them. Other associated factors of comprehensive disability were education level and financial support from children for empty nesters, and were marital status and monthly income for non-empty-nesters. So targeted interventions delivered to these two groups should be different.