Intergenerational support and depressive symptoms: Moderating effects of community services and smart health devices

Prior research suggests that intergenerational support can buffer depressive symptoms among older adults, yet the roles of community services and digital health technologies remain under-explored. We examined whether community service support and use of smart-health devices moderate the association between intergenerational support and depressive symptoms among Chinese older adults.

We analyzed two waves (2018, 2020) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 4054 older adults. A multilevel mixed-effects model was employed to account for both community-level clustering and unobserved time-invariant confounders. Intergenerational support was the primary predictor, community service support and smart health device use were specified as moderating variables, and depressive symptoms was the outcome.

In the fully adjusted model, intergenerational support, community service support, and smart health device use were each independently associated with lower depressive symptom scores. A significant two-way interaction between intergenerational support and smart health device use indicated that the protective association of intergenerational support with depressive symptoms was attenuated among users of smart devices. Moreover, the three-way interaction involving intergenerational support, community service support, and smart device use was also significant, suggesting a synergistic effect of "family+community+technology" in mitigating depressive symptoms among older adults.

Rather than implying causality, these findings demonstrate that intergenerational support, community services, and smart health devices jointly shape mental health-especially when all three resources coexist. Policies aiming to reduce late-life depression should foster integrated interventions that combine familial, community, and technological supports.