Family Structure and Its Changes and Depressive Symptoms in Later Life: How Intergenerational Support Makes a...

Depressive symptoms are common among middle-aged and older adults. This study examined the associations of family structure and its transitions with depressive symptoms, and the mediating role of intergenerational support.

Participants were drawn from the first five waves of CHARLS. Family structure and transitions were assessed at baseline (Wave 1) and Wave 2. Outcome was defined as new-onset depressive symptoms occurring after Wave 2 among participants who were free of depressive symptoms at both Wave 1 and Wave 2. A Cox proportional hazards model was used to examine the association between family structure/transitions and incident depressive symptoms. Parallel mediation analysis was conducted to examine the potential mediating effects of intergenerational support.

Compared with two-generation households, skipped-generation households were associated with a higher risk of depressive symptoms in older adults (HR = 1.30, 95% CI: 1.04-1.63), and transitions from two-generation to skipped-generation households were also associated with a higher risk (HR = 1.54, 95% CI: 1.06-2.23). Emotional support partially mediated this association.

Older adults living in or transitioning to skipped-generation households are associated with a higher risk of depressive symptoms, suggesting that public health efforts should prioritize skipped-generation households and the processes leading to their formation.