Do Intergenerational Bonds Reduce Depression Risk in Aging China? Evidence from a Nationwide Cohort

Do Intergenerational Bonds Reduce Depression Risk in Aging China? 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Evidence from a Nationwide Cohort Liangwen Zhang, Xinyi Wang, Wenzheng Zhang, Ya Fang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6455468/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Although existing research has linked family intergenerational relationships with psychosocial depressive conditions in older adults, the mechanisms and conditions associated with these relationships remain underexplored. We categorize the main patterns of family intergenerational relationships in China. Further we examined how social engagement moderates the relationship between family intergenerational relationship patterns and depression. Methods The data were collected from the Chinese Longitudinal Healthy Longevity Survey (2011–2018, wave 1–3), which utilized latent class analysis to identify family intergenerational relationship patterns among 9,765 eligible older adults. Generalized linear models were then utilized to explore the influence mechanisms between different intergenerational relationship patterns and geriatric mental health. Results Based on the results of the latent class analysis and the four dimensions of the intergenerational solidarity model (residential distance, connection, emotion, and function), four relationship types were identified: Tight-Knit, Support-Distant, Alienation-Close, and Detached. Generalized linear modeling analysis revealed that detached family intergenerational relationships, education, self-rated health, and self-rated quality of life had significant effects on depressive symptoms in older adults ( P < 0.001). Social participation (including recreational and social activities) moderated the relationship between family intergenerational dynamics and depressive symptoms ( P < 0.001). Higher levels of social participation notably mitigated the negative impact of detached family intergenerational relationships on depressive symptoms in older adults ( r = -0.176, P < 0.001). Conclusions Distant family ties heighten depression risk in older adults. Although social involvement can't fully substitute family support, it partially relieves depressive symptoms. As family is society's basic unit and linked to older adults, gaps in family support should encourage engagement in social activities and 'active aging'. This helps them rediscover self-worth and address mental health challenges from strained family ties, ultimately reducing depression risk. Mental health depressive symptoms intergenerational relationships Chinese older adults Figures Figure 1 Figure 2 Figure 5 1. Introduction The global problem of population ageing is becoming increasingly serious, and China, as a developing country with the largest number of older adults people in the world and a relatively serious degree of ageing, is currently in a period of rapid growth in population ageing. As per capita life expectancy increases and the fertility rate continues to decline, ageing is taking on the appearance of a large base, a rapid growth rate, and a trend of gradual affluence and rapid ageing. 1 However, the state of mental health of older persons, which is an important aspect of their well-being in later life, often fails to attract sufficient attention from all parties. Among them, depression, a common psychological problem among older adults, deserves special attention. Approximately 14% of adults aged 60 and older are diagnosed with a mental disorder. According to the Global Health Estimates (GHE) 2019, among older adults, these conditions account for 10.6% of the overall disability burden, measured in disability-adjusted life years (DALYs). Within this population, the most prevalent mental health disorders are depression and anxiety. Furthermore, GHE 2019 indicates that globally, nearly a quarter (27.2%) of suicide-related fatalities occur among individuals aged 60 or above. Numerous relevant studies conducted in recent years have also demonstrated that the proportion of older adults experiencing depressive symptoms, as well as the burden of disease caused by depression, is gradually increasing. Consequently, addressing depression in older adults and promoting positive aging has emerged as a pressing global social issue. The concept of "generation", first proposed by the German philosopher Karl Mannheim, refers to a generation of people who share the same social and historical location, and whose patterns of thought, experience and action are characterized by similarities. Where intergenerational relations refer to the interactions between these generations. 2 On this basis, with the in-depth study of intergenerational relations by many scholars, the concept of intergenerational relations has gradually evolved into two dimensions, broad and narrow. Intergenerational relations in the broad sense refer to the interaction and interaction between generations sharing different social and historical characteristics, while in the narrow sense they refer to the interaction between two generations of children and relatives, or three generations of grandparents and grandchildren, within a family due to blood and marriage. 3 We focus on intergenerational relationships at a narrow level, exploring family intergenerational relationship patterns in families with two generations of children and parents based on the intergenerational solidarity model. Different relationship patterns containing four dimensions, including residential distance, connection, emotion, and function, are identified and aggregated through a typological approach, and each specific intergenerational relationship pattern corresponds to its own specific individual and family characteristics. 4 According to life cycle theory, the evolution of dynamics within the family plays a crucial role in the experience of older people in later life. 5 Under this framework, intergenerational relationships, as the foundation of family old age, not only constitute the most crucial relationship pattern within the family, but also deeply intertwine the complex multiple dimensions of interdependence, mutual support for survival and spiritual comfort among family members. In recent years, more and more studies have begun to focus on the shaping of intergenerational family relationships in the late-life experiences of the older adults. Empirical studies in family gerontology have revealed the irreplaceable value of adult child support in maintaining the mental health of older persons. 6 Social convoy studies find parent/child relationships are central in late life. The quality of intergenerational relationships can be significantly improved through intergenerational cohabitation, increased frequency of contact with children, and supportive communication. 7 This positive effect is rooted in the fact that adult children are members of the core social network of older persons who remain stable throughout their aging process and can provide substantial and emotional intergenerational support. However, when family dysfunction occurs, the negative effects often appear first in the form of intergenerational alienation. 8 The accumulation of children's personal stress and intergenerational emotional conflicts is very likely to deepen the loneliness feeling of older parents, which in turn becomes an important risk factor for inducing depressive mood. 9 The weakening or absence of family functions may trigger complex changes in intergenerational family relationships, which may weaken the support and bonds among family members. If left unattended, it may have long-term and profound effects on the psychological state of older persons, including increased risk of mental health problems such as depression. Social participation may be an effective way to compensate for the lack of family functioning. 10 Relevant studies have shown that social participation can not only change the health behaviors of the older adults, but also play a protective role against the occurrence of depression, enhance the psychological health and well-being of the older adults, and help to improve their cognitive ability and prolong their survival time. 11 Social participation has its positive aspects and becomes a key way to achieve active ageing. 12 Regrettably, the current academic exploration of the mental health of the older adults is mostly limited to a single-family dimension, with too much attention paid to the identification and analysis of intergenerational family relationships, making in-depth studies of the diversity of family relationships and their impact on the differentiation of the psychological state of the older adults still insufficient. Fewer studies have explored whether the social participation of the older adults can, to a certain extent, replace the family function to provide support for their psychology. Therefore, based on national survey data and controlling for individual characteristics, this paper aims to identify the current status and characteristics of current intergenerational family relationship patterns in China, analyze the impact of intergenerational family relationships on older adults' depressive symptoms, and further explore the role of social participation in the chain of influence. 2. Methods 2.1. Data and sample The data in this paper are derived from the longitudinal tracking data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) on factors influencing healthy longevity of the older adults in China from 2011 to 2018. The reasons for selecting this data are as follows. (i) The survey was conducted in 24 provinces, municipalities and autonomous regions across the country, with random sampling based on age distribution, covering the majority of China's population. The data is widely used and authoritative in the field of geriatric health. The results studied in the data have a high degree of recognition. (ii) The survey simultaneously covered multiple sociodemographic key variables such as intergenerational relationships, mental health, and social participation among older adults. This fits with the purpose of this paper to examine the relationship between intergenerational relationships and depressive symptoms in older adults. (iii) The theme of the study was to explore the relationship between intergenerational family relationships and depression in older adults. Due to the inertia of demographic factors, the overall change in the older population over a five-year period is relatively slow, and the impact of different types of family relationships on the mental health of the older adults, as well as the moderating role of social support therein, does not change significantly in importance or regularity in the short to medium term. 13 Therefore, using this data can better reflect the current characteristics related to the older population and the mental health problems they face in China, as well as stably demonstrate the regularity of the long-term influence of family factors and social participation on the depressive symptoms of the older adults. This data can well fulfill the need for the purpose of this study. Samples aged ≥ 65 years who explicitly answered the family intergenerational relationship question item in the questionnaire were included, and missing values were filled in using the Missforest method of machine learning, 14 and a total of 9,765 samples were included. 2.2 Measures 2.2.1. Dependent variable The dependent variable in this paper is depressive symptoms, which are expressed using the depression score profile of the respondents. The variable was measured using the simplified version of the CES-D Depression Scale ( Cronbach's alpha of 0.755 ) from the CLHLS questionnaire. The scale was developed by Radloff of the National Institute of Mental Health in 1977 and is used primarily to assess the frequency of depressive symptoms or feelings that have occurred over the course of the past week. Its shortened version contains 10 entries from the full scale of the Depression Scale for Streaming Centers. 15 The scale options were all rated on a 4-point scale: "Always = 3, Often = 2, Sometimes or Less often = 1, Never = 0," with a total score range of 0–30, with higher scores indicating more severe depressive symptoms in older adults. 16 2.2.2. Independent variable The core independent variables were family intergenerational relationship patterns and social participation. The construction of family intergenerational relationship variables is based on the Intergenerational solidarity (IS) model. 17 The intergenerational solidarity model divides family relationships into four dimensions involving residential distance, contact, emotion, and function. Distance: whether or not you live with older adults; contact dimension: whether or not you visit often and whether or not you have frequent contact; emotional dimension: who you talk to first when you have something on your mind or a thought; and functional dimension: main source of livelihood, main caregiver. 2.2.3. Moderator variable The moderator variable is social participation. Social participation consists mainly of household chores, leisure and recreation, and social interaction activities. 12 Based on the purpose of the study and the accessibility of the variables, this paper mainly adopts two types of social participation: leisure and recreation and social interaction activities. Specific question entries include: whether or not they participate in outdoor activities, play cards or mahjong, watch television or listen to the radio, read books and newspapers, and participate in organized social activities. Each activity was assigned a value of 5 − 1 for "almost every day, at least once a week, at least once a month, sometimes, and do not participate", and the entries were summed to calculate a score ranging from 5–25, with the higher the score, the higher the degree of social participation of the older adults ( Cronbachs alpha of 0.937 ). 2.2.4. Covariate Based on the reference to the relevant research literature, the covariates mainly included gender, age, education level, type of urban-rural residence, self-rated quality of life, self-rated health status, Instrumental Activities of Daily Living (IADL) and Basic Activities of Daily Living (BADL). 2.3. Intergenerational solidarity model Intergenerational relationships serve as a vital channel for emotional comfort and social support among older adults. Bengtson and Robert's IS model illuminates the multidimensional nature of these relationships, emphasizing latent dimensions like interaction, emotion, and consensus, alongside explicit behavioral norms such as functional support and structural arrangements. 18 Recent studies have streamlined the model into three core dimensions—function, structure, and emotion. 19 Building on this framework, our study incorporates spatial proximity and supportive exchanges to form four dimensions: distance, connection, emotion, and function. This approach aims to uncover latent categories of intergenerational family relationships while revealing their internal mechanisms and external manifestations (Fig. 1 ). 3. Results 3.1. Latent class analysis model build Using Akaike and Bayesian information criteria (AIC/BIC), we identified four optimal latent classes through systematic testing of 2–7 category solutions (Table 1 ). Our analysis, grounded in the intergenerational solidarity framework, revealed distinct patterns moderated by traditional filial piety norms. Notably, cohabitation demonstrated an inverse relationship with visitation frequency among older adults. The emergent typology categorizes family relationships along residential proximity and multidimensional solidarity (affective, functional, financial) (Fig. 1 ): Tight-Knit (TK) : Co-resident/proximal families with strong multidimensional solidarity (highest probabilities across all dimensions) Alienation-Close (AC) : Geographically proximate but emotionally/functionally detached (high cohabitation probability, low solidarity measures) Support-Distant (SD) : Geographically distant yet maintaining functional/emotional ties Detached (DT) : Distant across all dimensions As shown in the longitudinal data (2011–2018), urban-rural disparities emerged: Urban TK prevalence increased from 13.8–42.4%, while rural TK declined from 11.7–23.9%; SD types decreased substantially in both settings (Urban:35.7%→1.2%; Rural:42.2%→0.5%); AC types exhibited inverse urban-rural trajectories (Urban:11.5%→33.6%; Rural:6.7%→51.4%); DT percentages remained stable in urban areas (39.0%→22.8%) but declined in rural regions (39.5%→24.3%). The hierarchy of relationship intimacy was consistent: TK > SD > AC > DT. This typology evolution reflects urbanization's dual effects - strengthening urban intergenerational ties through improved connectivity while exacerbating rural familial fragmentation through migration patterns. Table 1 Urban and rural distribution of intergenerational family relations Support-Distant Alienation-Close Detached Tight-Knit 2011 Urban 1650(35.7%) 531(11.5%) 1800(39.0%) 639(13.8%) Rural 2169(42.2%) 345(6.7%) 2031(39.5%) 600(11.7%) 2014 Urban 340(8.7%) 2202(56%) 111(2.8%) 1276(32.5%) Rural 599(10.3%) 2878(49.3%) 135(2.3%) 2224(38.1%) 2018 Urban 61(1.2%) 1665(33.6%) 1132(22.8%) 2104(42.4%) Rural 22(0.5%) 2467(51.4%) 1165(24.3) 1149(23.9%) 3.2. Regression analysis of factors influencing depressive symptoms in older adults To further explore the influence of different factors on depression symptoms in older adults, individual characteristics, type of social participation, and type of family intergenerational relationship were gradually incorporated into the generalized linear model to observe the influence of different factors on depression symptoms (Table 4). Model 1 is a baseline model that incorporates basic individual characteristics; female, uneducated, poorer self-assessed quality of life, and health status are significant risk factors for depressive symptoms in older adults ( P < 0.001 ), whereas older adults who reside in rural areas and who have higher levels of social participation have lower depressive symptom scores ( P < 0.001 ) and are in better mental health. Model 2 incorporates four types of family intergenerational relationship variables on the basis of Model 1. After controlling for basic individual characteristics, all four types of family intergenerational relationship types have a significant effect on the depression level of older adults ( P < 0.01 ). Depression levels were significantly higher among older adults in detached family relationships than among older adults in other family relationship types. Tight-Knit and Support-Distant family relationships negatively affected older adults' depressive symptoms. This suggests that family intergenerational relationships that are closer in terms of bonding, affective, and functional dimensions will be effective in reducing the level of depressive symptoms in older adults. In contrast, increased intergenerational family relationships of the Alienation-Close and Detached types can lead to increased levels of depression in older adults, which in turn may trigger the onset of depression in older adults. Other variables remained largely unchanged from Model 1 coefficients, direction and significance. Table 2 Analysis of the factors influencing depressive symptoms in older adults from 2011 to 2018 Variable Model 1 Model 2 Support-Distant Alienation-Close Detached Tight-Knit Intergenerational relationship type -0.33 *** 0.214 *** 0.28 *** -0.346 *** Sex(Female) 0.276 *** 0.255 *** 0.278 *** 0.256 *** 0.277 *** Age -0.08 *** -0.009 *** -0.006 *** -0.011 *** -0.008 *** Education(Illiterate) 0.273 *** 0.264 *** 0.263 *** 0.274 *** 0.267 *** Residence (Rural) -0.143 *** 0.137 *** 0.133 *** 0.14 *** 0.130 *** Quality of Life(Bad) 1.026 *** 1.042 *** 1.047 *** 1.01 *** 1.024 *** Self-reported Health (Bad) 1.293 *** 1.234 *** 1.222 *** 1.327 *** 1.282 *** BADL 0.064 0.057 0.061 -0.06 * -0.064 IADL 0.021 0.020 0.017 0.017 0.015 Social Participation -0.007 0.084 0.085 0.083 0.085 (Intercept) 9.147 9.081 9.018 9.804 9.059 Note: The table gives the linear regression coefficients. ∗ P <0.05, ∗∗ P <0.01, ∗∗∗ P <0.001 3.3. The moderating impact of social engagement on intergenerational alienation and depressive symptoms According to the results of the analysis of the generalized linear model regression, it can be found that the family intergenerational relationships that are more sorted out in the dimensions of emotion, connection and functioning have higher depression scores. Meanwhile, social participation was not significant in both models 1 and 2. In this paper, we would like to further discuss whether social participation can alleviate the effect of detached family relationships on depressive symptoms of older adults to a certain extent. Therefore, this paper adds the interaction term between social participation and family intergenerational relationships to Model 2 to further test whether social participation moderates the correlation between family intergenerational relationships and depression levels after controlling for factors such as basic demographic characteristics. The results showed that there was a moderating effect of the interaction term of social participation and family intergenerational relationships between all three types of family intergenerational relationships and depression among older adults except for the Detached type ( P < 0.001 ), which was able to significantly reduce depressive symptoms to some extent. This also demonstrates that social participation cannot completely replace the functions that distance and the connectedness, affective, and functional dimensions have in the mental health of older adults. The moderating effect of social participation is also minimal when the above family functions are not working. Table 3 The moderating effect of social participation on family intergenerational relations and depressive symptoms Variable Coefficients Standard Error Independent Variable Support-Distant -0.781 *** 0.006 Alienation-Close 0.597 *** 0.187 Detached 0.236 0.202 Tight-Knit -0.953 *** 0.232 Moderator Social participation -0.078 0.013 Interaction Term Social participation × SD -0.019 *** 0.006 Social participation × AC -0.023 *** 0.015 Social participation × DT -0.002 0.027 Social participation × TK -0.030 ** 0.011 Note: The table gives the linear regression coefficients. ∗ P <0.05, ∗∗ P <0.01, ∗∗∗ P <0.001 4. Discussion Our findings align with the intergenerational solidarity theory's spatial proximity dimension, revealing a predominant pattern of co-residence or proximate living arrangements in East Asian multigenerational families. This spatial cohesion reflects deeply rooted cultural values of filial piety that reinforce intergenerational bonds - an integration of psychological attachment mechanisms and social support systems. 20,21 The Chinese intergenerational resource flow uniquely combines reciprocal exchange dynamics with hierarchical nurturing-supportive functions, 22 creating stronger intergenerational ties than typically observed in Western societies. These culturally specific relational patterns carry significant implications for older adults' mental health outcomes through their mediation of emotional security and social embeddedness. Our analysis reveals critical urban-rural disparities in intergenerational dynamics. Urban older adults exhibited fewer detached intergenerational ties and greater filial dependence compared to rural counterparts, maintaining stronger parent-child bonds. 23 This spatial advantage facilitates frequent intergenerational contact through improved transportation and digital communication infrastructure. However, the accelerating urbanization process has intensified pressure on China's traditional elder care system, particularly through the emergence of "4-2-1" family structures (four grandparents, two working parents, one child). 24 These vertically compressed kinship networks create downward redistribution of family resources, potentially undermining older adults' expectations of reciprocal care arrangements. Notably, migrant older adults in urban centers demonstrated greater reliance on emotional support rather than financial assistance—a compensatory adaptation to adult children's urban relocation and resource constraints. 24 These findings highlight urbanization's dual role in both enabling and challenging intergenerational solidarity, necessitating policy frameworks that address evolving care dynamics across urban-rural divides. Our findings corroborate established evidence linking lower educational attainment, poorer self-rated health, and diminished quality of life with elevated depression risk in older adults - consistent with national epidemiological patterns (37.52% prevalence among Chinese elders). 24 Self-determination theory elucidates these associations through the erosion of autonomy and perceived control accompanying aging processes. 25 The recursive cycle of physical decline → diminished life engagement → psychological vulnerability creates existential dissonance when older adults confront their narrowing spheres of influence. 26 Socioeconomic buffers including financial security, community affluence, and leisure access reduced depression risk by 20% in our analysis, 27 underscoring environmental moderators of developmental stress. This life-stage transition demands successful cognitive-behavioral recalibration. Therapeutic interventions should promote developmental reappraisal - reframing age-related changes as normative life-cycle transitions while fostering social participation. Public health strategies must address both structural determinants (education, healthcare access) and psychological adaptation mechanisms to disrupt depression pathways in aging populations. Our findings reveal intergenerational relational deficits (emotional, functional, and communicative) as significant predictors of geriatric depression, with social engagement failing to compensate for family estrangement effects. Family systems theory elucidates this phenomenon through its emphasis on relational homeostasis - psychological distress in older adults often manifests systemic dysfunctions within kinship networks rather than individual pathology. 28 The widening gap between filial expectations shaped by traditional caregiving norms and contemporary intergenerational realities creates developmental mismatch, particularly evident in urbanizing Chinese families experiencing intergenerational contract imbalances. 29 Our analysis identifies social participation as a psychosocial buffering mechanism that partially mitigates - but cannot fully substitute - the mental health consequences of intergenerational estrangement. While engagement in social-recreational activities demonstrates depression-reduction effects through dual pathways of self-actualization and social embeddedness, 30,31 its compensatory capacity remains constrained by the irreplaceable nature of familial emotional bonds. This partial efficacy aligns with social participation theory's emphasis on multidimensional engagement, where voluntary work and intergenerational mentoring emerge as particularly effective buffers against aging-related anomie. 12,32 These findings necessitate multilevel policy innovations: 1) Developing adaptive employment frameworks that harness older adults' human capital through phased retirement systems; 2) Creating hybrid care models integrating family support with community-based engagement platforms; 3) Implementing age-friendly urban designs that reduce physical barriers to social participation. Crucially, recent empirical work demonstrates that such structural interventions can increase older adults' positive affect while reducing caregiving pressures on younger generations. Strengths and Limitations: Our findings should be interpreted within methodological and cultural contexts. The nationally representative data enhance ecological validity in examining social participation's mediating role between intergenerational dynamics and late-life depression. However, the observational design inherently limits causal inference, with potential residual confounding from unmeasured variables (e.g., childhood adversity, marital quality). Cross-cultural measurement limitations emerge in depression assessment, where sociocultural desirability biases may underreport symptoms, particularly among male and rural-dwelling elders. Future investigations should employ mixed-methods approaches combining actigraphy-measured social engagement with dyadic family assessments. Policy piloting of intergenerational co-participation programs could simultaneously test intervention efficacy while addressing ageism stigma. These advancements would strengthen both the scientific understanding and practical implementation of relational health paradigms in aging populations. 5. Conclusion Our study looked at the impact of intergenerational family relationships on depression in older adults and tapped into the role of social engagement in this context. There is heterogeneity in the effects of different types of intergenerational family relationships on the mental health of older adults, and estranged family relationships increase the risk of depression in older adults. Although social engagement can alleviate depression to a certain extent, it cannot completely replace family intergenerational ties in helping older adults' mental health. Abbreviations IS model: Intergenerational solidarity model IADL: Instrumental Activities of Daily Living BADL: Basic Activities of Daily Living TK: Tight-Knit type (Co-resident/proximal families with strong multidimensional solidarity ) AC: Alienation-Close type (Geographically proximate but emotionally/functionally detached) SD: Support-Distant type (Geographically distant yet maintaining functional/emotional ties) DT: Detached type (Distant across all dimensions) Declarations [Ethics approval and consent to participate] The data used in this study were obtained from the publicly available Chinese Longitudinal Healthy Longevity Survey (CLHLS). The original CLHLS protocol was reviewed and approved by the institutional review boards of Peking University , with all participants or their proxies providing signed informed consent. As this study involved only secondary analysis of anonymized data from this established database, no additional ethics approval was required. [Consent for publication] Not applicable. [Availability of data and materials] The raw data supporting this study are available from the Chinese LongitudinalHealthy Longevity Survey (CLHLS) team upon application. Processed datasets generated during the current study are available from the corresponding author on reasonable request. [Competing Interests] The authors declare no competing interests. [Funding] This study was supported by the National Key Research and Development Program of China (grant number 2022YFC3603004), the Social Science Foundation of Fujian Province (grant number FJ2022C047) and the Xiang'an Innovation Lab Incubation Programme of Xiamen (grant number 2023XAKJ0101032). [Authors' contributions] LWZ conceptualised the research design, analysed and discussed the data, and reviewed and revised the paper. XYW conceptualised the research questions, analysed the data, discussed the results, and reviewed and revised the paper. ZWZ collated and analysed the data, and was responsible for drafting the first draft of the paper. YF co-ordinated the overall research design, participated in the interpretation of the results, and reviewed and revised the paper. All authors certify that they have no affiliations with or involvement in any organization or entitywith any financial interest or non-financial interest in the subject matter or materials discussed inthis manuscript. [Acknowledgements] We are grateful to the National Key Research and Development Program of China, the Social Science Foundation of Fujian Province and the Xiang'an Innovation Lab Incubation Programme of Xiamen for their support and to all the teachers and students at the Centre for Health Economics and Policy Research, Xiamen University for their help. References Bengtson VL, Roberts REL. Intergenerational Solidarity in Aging Families: An Example of Formal Theory Construction. J Marriage Family. 1991;53:856–70. 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Karl Mannheim's Quintessence. Contemporary Academic Prism Translation Series. Nanjing University; 2002. Zhang WZ, Zhang LW, Fang Y. Research on the relationship between intergenerational relationship patterns in families and depressive symptoms in Chinese elderly. Med Soc. 2024;37:93–9. Wu CP. Social Gerontology. China Renmin University; 1999. Hao SC, Zhou Z, Fang Y. Interaction and combined effects of living arrangements and loneliness on self-rated health of the elderly. Chin J Gerontol. 2016;36:2502–5. Que S, Zeng YB, Fang Y. Research on the impact of social participation on cognitive function of Chinese elderly based on fixed effects model. Chin J Health Stat. 2023;40:36–40. Chen JY, Fang Y, Zeng YB. Research on the impact of multiple social participation and family support on mental health of Chinese elderly. Chin J Health Policy. 2021;14:45–51. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6455468","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":468795780,"identity":"57ec38ad-4de9-4769-9759-8880af38f231","order_by":0,"name":"Liangwen Zhang","email":"","orcid":"","institution":"School of Public Health, Xiamen University","correspondingAuthor":false,"prefix":"","firstName":"Liangwen","middleName":"","lastName":"Zhang","suffix":""},{"id":468795781,"identity":"08201c41-e3fc-4451-a2cc-4867564fe1e5","order_by":1,"name":"Xinyi Wang","email":"","orcid":"","institution":"School of Public Health, Xiamen University","correspondingAuthor":false,"prefix":"","firstName":"Xinyi","middleName":"","lastName":"Wang","suffix":""},{"id":468795782,"identity":"44c58662-fcde-4e10-8b5c-d19b477c298a","order_by":2,"name":"Wenzheng Zhang","email":"","orcid":"","institution":"School of Public Health, Xiamen University","correspondingAuthor":false,"prefix":"","firstName":"Wenzheng","middleName":"","lastName":"Zhang","suffix":""},{"id":468795783,"identity":"7f9f6e8c-7b9a-4c29-8021-78f8392f230c","order_by":3,"name":"Ya Fang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAw0lEQVRIiWNgGAWjYBAC9gYwZQPh8RCjhecAmEojXcthUrSwnz38mqfmfOLaGQmMD962McibE9TCk5dmzXPstrHZjQRmw7ltDIY7GwhosWfIMTPmYbstB9TCJs3bxpBgcICQLfxvgFr+neMBamH/TZwWiRzjx7xtB8C2MBOp5Y0Z49y+ZGOzMw+bJeeckzDcQNhhOcYf3nyzS9x2PPnghzdlNvIEbQECNilIdDA2AAkJwuqBgPnjD6LUjYJRMApGwYgFAHrjPOFMy1CUAAAAAElFTkSuQmCC","orcid":"","institution":"School of Public Health, Xiamen University","correspondingAuthor":true,"prefix":"","firstName":"Ya","middleName":"","lastName":"Fang","suffix":""}],"badges":[],"createdAt":"2025-04-15 13:53:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6455468/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6455468/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84415754,"identity":"f73b0fe7-ba04-49f2-99dc-3abd3ba2e83b","added_by":"auto","created_at":"2025-06-11 16:29:40","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":47662,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eConceptual diagram of the application of the intergenerational solidarity model.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6455468/v1/a8e28b8d56f0392fbf6007f7.jpeg"},{"id":84414673,"identity":"66247571-0839-457c-8dc1-6752c964994f","added_by":"auto","created_at":"2025-06-11 16:13:40","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":232331,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFamily intergenerational relationship type responds to probability polyline.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6455468/v1/eb42dbaa094196c609ba9d85.jpeg"},{"id":84414667,"identity":"16c7e573-5424-4bb7-9477-a380a01857d0","added_by":"auto","created_at":"2025-06-11 16:13:40","extension":"jpeg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":47662,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eConceptual diagram of the application of the intergenerational solidarity model.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6455468/v1/612a7f63265c2416150f0425.jpeg"},{"id":84415923,"identity":"086eb3aa-7ce1-4429-a11c-e02eb0a38aeb","added_by":"auto","created_at":"2025-06-11 16:37:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1338861,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6455468/v1/fbeb27f1-3fa1-4e1b-8fba-c05e920f7080.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Do Intergenerational Bonds Reduce Depression Risk in Aging China? Evidence from a Nationwide Cohort","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe global problem of population ageing is becoming increasingly serious, and China, as a developing country with the largest number of older adults people in the world and a relatively serious degree of ageing, is currently in a period of rapid growth in population ageing. As per capita life expectancy increases and the fertility rate continues to decline, ageing is taking on the appearance of a large base, a rapid growth rate, and a trend of gradual affluence and rapid ageing.\u003csup\u003e1\u003c/sup\u003e However, the state of mental health of older persons, which is an important aspect of their well-being in later life, often fails to attract sufficient attention from all parties. Among them, depression, a common psychological problem among older adults, deserves special attention. Approximately 14% of adults aged 60 and older are diagnosed with a mental disorder. According to the Global Health Estimates (GHE) 2019, among older adults, these conditions account for 10.6% of the overall disability burden, measured in disability-adjusted life years (DALYs). Within this population, the most prevalent mental health disorders are depression and anxiety. Furthermore, GHE 2019 indicates that globally, nearly a quarter (27.2%) of suicide-related fatalities occur among individuals aged 60 or above. Numerous relevant studies conducted in recent years have also demonstrated that the proportion of older adults experiencing depressive symptoms, as well as the burden of disease caused by depression, is gradually increasing. Consequently, addressing depression in older adults and promoting positive aging has emerged as a pressing global social issue.\u003c/p\u003e \u003cp\u003eThe concept of \"generation\", first proposed by the German philosopher Karl Mannheim, refers to a generation of people who share the same social and historical location, and whose patterns of thought, experience and action are characterized by similarities. Where intergenerational relations refer to the interactions between these generations.\u003csup\u003e2\u003c/sup\u003e On this basis, with the in-depth study of intergenerational relations by many scholars, the concept of intergenerational relations has gradually evolved into two dimensions, broad and narrow. Intergenerational relations in the broad sense refer to the interaction and interaction between generations sharing different social and historical characteristics, while in the narrow sense they refer to the interaction between two generations of children and relatives, or three generations of grandparents and grandchildren, within a family due to blood and marriage.\u003csup\u003e3\u003c/sup\u003e We focus on intergenerational relationships at a narrow level, exploring family intergenerational relationship patterns in families with two generations of children and parents based on the intergenerational solidarity model. Different relationship patterns containing four dimensions, including residential distance, connection, emotion, and function, are identified and aggregated through a typological approach, and each specific intergenerational relationship pattern corresponds to its own specific individual and family characteristics.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAccording to life cycle theory, the evolution of dynamics within the family plays a crucial role in the experience of older people in later life.\u003csup\u003e5\u003c/sup\u003e Under this framework, intergenerational relationships, as the foundation of family old age, not only constitute the most crucial relationship pattern within the family, but also deeply intertwine the complex multiple dimensions of interdependence, mutual support for survival and spiritual comfort among family members. In recent years, more and more studies have begun to focus on the shaping of intergenerational family relationships in the late-life experiences of the older adults. Empirical studies in family gerontology have revealed the irreplaceable value of adult child support in maintaining the mental health of older persons.\u003csup\u003e6\u003c/sup\u003e Social convoy studies find parent/child relationships are central in late life. The quality of intergenerational relationships can be significantly improved through intergenerational cohabitation, increased frequency of contact with children, and supportive communication.\u003csup\u003e7\u003c/sup\u003e This positive effect is rooted in the fact that adult children are members of the core social network of older persons who remain stable throughout their aging process and can provide substantial and emotional intergenerational support. However, when family dysfunction occurs, the negative effects often appear first in the form of intergenerational alienation.\u003csup\u003e8\u003c/sup\u003e The accumulation of children's personal stress and intergenerational emotional conflicts is very likely to deepen the loneliness feeling of older parents, which in turn becomes an important risk factor for inducing depressive mood.\u003csup\u003e9\u003c/sup\u003e The weakening or absence of family functions may trigger complex changes in intergenerational family relationships, which may weaken the support and bonds among family members. If left unattended, it may have long-term and profound effects on the psychological state of older persons, including increased risk of mental health problems such as depression.\u003c/p\u003e \u003cp\u003eSocial participation may be an effective way to compensate for the lack of family functioning.\u003csup\u003e10\u003c/sup\u003e Relevant studies have shown that social participation can not only change the health behaviors of the older adults, but also play a protective role against the occurrence of depression, enhance the psychological health and well-being of the older adults, and help to improve their cognitive ability and prolong their survival time.\u003csup\u003e11\u003c/sup\u003e Social participation has its positive aspects and becomes a key way to achieve active ageing.\u003csup\u003e12\u003c/sup\u003e Regrettably, the current academic exploration of the mental health of the older adults is mostly limited to a single-family dimension, with too much attention paid to the identification and analysis of intergenerational family relationships, making in-depth studies of the diversity of family relationships and their impact on the differentiation of the psychological state of the older adults still insufficient. Fewer studies have explored whether the social participation of the older adults can, to a certain extent, replace the family function to provide support for their psychology. Therefore, based on national survey data and controlling for individual characteristics, this paper aims to identify the current status and characteristics of current intergenerational family relationship patterns in China, analyze the impact of intergenerational family relationships on older adults' depressive symptoms, and further explore the role of social participation in the chain of influence.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Data and sample\u003c/h2\u003e \u003cp\u003eThe data in this paper are derived from the longitudinal tracking data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) on factors influencing healthy longevity of the older adults in China from 2011 to 2018. The reasons for selecting this data are as follows. (i) The survey was conducted in 24 provinces, municipalities and autonomous regions across the country, with random sampling based on age distribution, covering the majority of China's population. The data is widely used and authoritative in the field of geriatric health. The results studied in the data have a high degree of recognition. (ii) The survey simultaneously covered multiple sociodemographic key variables such as intergenerational relationships, mental health, and social participation among older adults. This fits with the purpose of this paper to examine the relationship between intergenerational relationships and depressive symptoms in older adults. (iii) The theme of the study was to explore the relationship between intergenerational family relationships and depression in older adults.\u003c/p\u003e \u003cp\u003eDue to the inertia of demographic factors, the overall change in the older population over a five-year period is relatively slow, and the impact of different types of family relationships on the mental health of the older adults, as well as the moderating role of social support therein, does not change significantly in importance or regularity in the short to medium term.\u003csup\u003e13\u003c/sup\u003e Therefore, using this data can better reflect the current characteristics related to the older population and the mental health problems they face in China, as well as stably demonstrate the regularity of the long-term influence of family factors and social participation on the depressive symptoms of the older adults. This data can well fulfill the need for the purpose of this study. Samples aged\u0026thinsp;\u0026ge;\u0026thinsp;65 years who explicitly answered the family intergenerational relationship question item in the questionnaire were included, and missing values were filled in using the Missforest method of machine learning,\u003csup\u003e14\u003c/sup\u003eand a total of 9,765 samples were included.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Measures\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1. Dependent variable\u003c/h2\u003e \u003cp\u003eThe dependent variable in this paper is depressive symptoms, which are expressed using the depression score profile of the respondents. The variable was measured using the simplified version of the CES-D Depression Scale (\u003cem\u003eCronbach's alpha of 0.755\u003c/em\u003e) from the CLHLS questionnaire. The scale was developed by Radloff of the National Institute of Mental Health in 1977 and is used primarily to assess the frequency of depressive symptoms or feelings that have occurred over the course of the past week. Its shortened version contains 10 entries from the full scale of the Depression Scale for Streaming Centers.\u003csup\u003e15\u003c/sup\u003e The scale options were all rated on a 4-point scale: \"Always\u0026thinsp;=\u0026thinsp;3, Often\u0026thinsp;=\u0026thinsp;2, Sometimes or Less often\u0026thinsp;=\u0026thinsp;1, Never\u0026thinsp;=\u0026thinsp;0,\" with a total score range of 0\u0026ndash;30, with higher scores indicating more severe depressive symptoms in older adults.\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2. Independent variable\u003c/h2\u003e \u003cp\u003eThe core independent variables were family intergenerational relationship patterns and social participation. The construction of family intergenerational relationship variables is based on the Intergenerational solidarity (IS) model. \u003csup\u003e17\u003c/sup\u003eThe intergenerational solidarity model divides family relationships into four dimensions involving residential distance, contact, emotion, and function. Distance: whether or not you live with older adults; contact dimension: whether or not you visit often and whether or not you have frequent contact; emotional dimension: who you talk to first when you have something on your mind or a thought; and functional dimension: main source of livelihood, main caregiver.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3. Moderator variable\u003c/h2\u003e \u003cp\u003eThe moderator variable is social participation. Social participation consists mainly of household chores, leisure and recreation, and social interaction activities.\u003csup\u003e12\u003c/sup\u003e Based on the purpose of the study and the accessibility of the variables, this paper mainly adopts two types of social participation: leisure and recreation and social interaction activities. Specific question entries include: whether or not they participate in outdoor activities, play cards or mahjong, watch television or listen to the radio, read books and newspapers, and participate in organized social activities. Each activity was assigned a value of 5\u0026thinsp;\u0026minus;\u0026thinsp;1 for \"almost every day, at least once a week, at least once a month, sometimes, and do not participate\", and the entries were summed to calculate a score ranging from 5\u0026ndash;25, with the higher the score, the higher the degree of social participation of the older adults (\u003cem\u003eCronbachs alpha of 0.937\u003c/em\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.2.4. Covariate\u003c/h2\u003e \u003cp\u003eBased on the reference to the relevant research literature, the covariates mainly included gender, age, education level, type of urban-rural residence, self-rated quality of life, self-rated health status, Instrumental Activities of Daily Living (IADL) and Basic Activities of Daily Living (BADL).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Intergenerational solidarity model\u003c/h2\u003e \u003cp\u003eIntergenerational relationships serve as a vital channel for emotional comfort and social support among older adults. Bengtson and Robert's IS model illuminates the multidimensional nature of these relationships, emphasizing latent dimensions like interaction, emotion, and consensus, alongside explicit behavioral norms such as functional support and structural arrangements.\u003csup\u003e18\u003c/sup\u003e Recent studies have streamlined the model into three core dimensions\u0026mdash;function, structure, and emotion.\u003csup\u003e19\u003c/sup\u003e Building on this framework, our study incorporates spatial proximity and supportive exchanges to form four dimensions: distance, connection, emotion, and function. This approach aims to uncover latent categories of intergenerational family relationships while revealing their internal mechanisms and external manifestations (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Latent class analysis model build\u003c/h2\u003e \u003cp\u003eUsing Akaike and Bayesian information criteria (AIC/BIC), we identified four optimal latent classes through systematic testing of 2\u0026ndash;7 category solutions (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Our analysis, grounded in the intergenerational solidarity framework, revealed distinct patterns moderated by traditional filial piety norms. Notably, cohabitation demonstrated an inverse relationship with visitation frequency among older adults.\u003c/p\u003e \u003cp\u003eThe emergent typology categorizes family relationships along residential proximity and multidimensional solidarity (affective, functional, financial) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e):\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eTight-Knit (TK)\u003c/b\u003e: Co-resident/proximal families with strong multidimensional solidarity (highest probabilities across all dimensions)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAlienation-Close (AC)\u003c/b\u003e: Geographically proximate but emotionally/functionally detached (high cohabitation probability, low solidarity measures)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eSupport-Distant (SD)\u003c/b\u003e: Geographically distant yet maintaining functional/emotional ties\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eDetached (DT)\u003c/b\u003e: Distant across all dimensions\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eAs shown in the longitudinal data (2011\u0026ndash;2018), urban-rural disparities emerged: Urban TK prevalence increased from 13.8\u0026ndash;42.4%, while rural TK declined from 11.7\u0026ndash;23.9%; SD types decreased substantially in both settings (Urban:35.7%\u0026rarr;1.2%; Rural:42.2%\u0026rarr;0.5%); AC types exhibited inverse urban-rural trajectories (Urban:11.5%\u0026rarr;33.6%; Rural:6.7%\u0026rarr;51.4%); DT percentages remained stable in urban areas (39.0%\u0026rarr;22.8%) but declined in rural regions (39.5%\u0026rarr;24.3%).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe hierarchy of relationship intimacy was consistent: TK\u0026thinsp;\u0026gt;\u0026thinsp;SD\u0026thinsp;\u0026gt;\u0026thinsp;AC\u0026thinsp;\u0026gt;\u0026thinsp;DT. This typology evolution reflects urbanization's dual effects - strengthening urban intergenerational ties through improved connectivity while exacerbating rural familial fragmentation through migration patterns.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUrban and rural distribution of intergenerational family relations\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSupport-Distant\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAlienation-Close\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDetached\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTight-Knit\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e2011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUrban\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1650(35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e531(11.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1800(39.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e639(13.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRural\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2169(42.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e345(6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2031(39.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e600(11.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e2014\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUrban\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e340(8.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2202(56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e111(2.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1276(32.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRural\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e599(10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2878(49.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e135(2.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2224(38.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e2018\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eUrban\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61(1.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1665(33.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1132(22.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2104(42.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRural\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22(0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2467(51.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1165(24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1149(23.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e\u003cb\u003e3.2. Regression analysis of factors influencing depressive symptoms in older adults\u003c/b\u003e\u003c/h2\u003e \u003cp\u003eTo further explore the influence of different factors on depression symptoms in older adults, individual characteristics, type of social participation, and type of family intergenerational relationship were gradually incorporated into the generalized linear model to observe the influence of different factors on depression symptoms (Table\u0026nbsp;4). Model 1 is a baseline model that incorporates basic individual characteristics; female, uneducated, poorer self-assessed quality of life, and health status are significant risk factors for depressive symptoms in older adults (\u003cem\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), whereas older adults who reside in rural areas and who have higher levels of social participation have lower depressive symptom scores (\u003cem\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e) and are in better mental health.\u003c/p\u003e \u003cp\u003eModel 2 incorporates four types of family intergenerational relationship variables on the basis of Model 1. After controlling for basic individual characteristics, all four types of family intergenerational relationship types have a significant effect on the depression level of older adults (\u003cem\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/em\u003e). Depression levels were significantly higher among older adults in detached family relationships than among older adults in other family relationship types. Tight-Knit and Support-Distant family relationships negatively affected older adults' depressive symptoms. This suggests that family intergenerational relationships that are closer in terms of bonding, affective, and functional dimensions will be effective in reducing the level of depressive symptoms in older adults. In contrast, increased intergenerational family relationships of the Alienation-Close and Detached types can lead to increased levels of depression in older adults, which in turn may trigger the onset of depression in older adults. Other variables remained largely unchanged from Model 1 coefficients, direction and significance.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of the factors influencing depressive symptoms in older adults from 2011 to 2018\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSupport-Distant\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAlienation-Close\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDetached\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTight-Knit\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntergenerational\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003erelationship type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.33\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.214\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.346\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex(Female)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.276\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.255\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.278\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.256\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.277\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.08\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.009\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.006\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.011\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.008\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation(Illiterate)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.273\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.264\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.263\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.274\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.267\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Rural)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.143\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.137\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.133\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.14\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.130\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuality of Life(Bad)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.026\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.042\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.047\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.01\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.024\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-reported Health\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Bad)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.293\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.234\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.222\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.327\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.282\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBADL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.06\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-0.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIADL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial Participation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e(Intercept)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.804\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: The table gives the linear regression coefficients. \u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, \u0026lowast;\u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.01, \u0026lowast;\u0026lowast;\u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3. The moderating impact of social engagement on intergenerational alienation and depressive symptoms\u003c/h2\u003e \u003cp\u003eAccording to the results of the analysis of the generalized linear model regression, it can be found that the family intergenerational relationships that are more sorted out in the dimensions of emotion, connection and functioning have higher depression scores. Meanwhile, social participation was not significant in both models 1 and 2. In this paper, we would like to further discuss whether social participation can alleviate the effect of detached family relationships on depressive symptoms of older adults to a certain extent. Therefore, this paper adds the interaction term between social participation and family intergenerational relationships to Model 2 to further test whether social participation moderates the correlation between family intergenerational relationships and depression levels after controlling for factors such as basic demographic characteristics. The results showed that there was a moderating effect of the interaction term of social participation and family intergenerational relationships between all three types of family intergenerational relationships and depression among older adults except for the Detached type (\u003cem\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e), which was able to significantly reduce depressive symptoms to some extent. This also demonstrates that social participation cannot completely replace the functions that distance and the connectedness, affective, and functional dimensions have in the mental health of older adults. The moderating effect of social participation is also minimal when the above family functions are not working.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe moderating effect of social participation on family intergenerational relations and depressive symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCoefficients\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandard Error\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eIndependent Variable\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSupport-Distant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.781\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlienation-Close\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.597\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.187\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDetached\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTight-Knit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.953\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.232\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerator\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eInteraction Term\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial participation \u0026times; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.019\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial participation \u0026times; AC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.023\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial participation \u0026times; DT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSocial participation \u0026times; TK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.030\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNote: The table gives the linear regression coefficients. \u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, \u0026lowast;\u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.01, \u0026lowast;\u0026lowast;\u0026lowast; \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eOur findings align with the intergenerational solidarity theory's spatial proximity dimension, revealing a predominant pattern of co-residence or proximate living arrangements in East Asian multigenerational families. This spatial cohesion reflects deeply rooted cultural values of filial piety that reinforce intergenerational bonds - an integration of psychological attachment mechanisms and social support systems.\u003csup\u003e20,21\u003c/sup\u003e The Chinese intergenerational resource flow uniquely combines reciprocal exchange dynamics with hierarchical nurturing-supportive functions,\u003csup\u003e22\u003c/sup\u003e creating stronger intergenerational ties than typically observed in Western societies. These culturally specific relational patterns carry significant implications for older adults' mental health outcomes through their mediation of emotional security and social embeddedness.\u003c/p\u003e \u003cp\u003eOur analysis reveals critical urban-rural disparities in intergenerational dynamics. Urban older adults exhibited fewer detached intergenerational ties and greater filial dependence compared to rural counterparts, maintaining stronger parent-child bonds.\u003csup\u003e23\u003c/sup\u003e This spatial advantage facilitates frequent intergenerational contact through improved transportation and digital communication infrastructure. However, the accelerating urbanization process has intensified pressure on China's traditional elder care system, particularly through the emergence of \"4-2-1\" family structures (four grandparents, two working parents, one child).\u003csup\u003e24\u003c/sup\u003e These vertically compressed kinship networks create downward redistribution of family resources, potentially undermining older adults' expectations of reciprocal care arrangements.\u003c/p\u003e \u003cp\u003eNotably, migrant older adults in urban centers demonstrated greater reliance on emotional support rather than financial assistance\u0026mdash;a compensatory adaptation to adult children's urban relocation and resource constraints.\u003csup\u003e24\u003c/sup\u003e These findings highlight urbanization's dual role in both enabling and challenging intergenerational solidarity, necessitating policy frameworks that address evolving care dynamics across urban-rural divides.\u003c/p\u003e \u003cp\u003eOur findings corroborate established evidence linking lower educational attainment, poorer self-rated health, and diminished quality of life with elevated depression risk in older adults - consistent with national epidemiological patterns (37.52% prevalence among Chinese elders).\u003csup\u003e24\u003c/sup\u003e Self-determination theory elucidates these associations through the erosion of autonomy and perceived control accompanying aging processes.\u003csup\u003e25\u003c/sup\u003e The recursive cycle of physical decline \u0026rarr; diminished life engagement \u0026rarr; psychological vulnerability creates existential dissonance when older adults confront their narrowing spheres of influence.\u003csup\u003e26\u003c/sup\u003e Socioeconomic buffers including financial security, community affluence, and leisure access reduced depression risk by 20% in our analysis,\u003csup\u003e27\u003c/sup\u003e underscoring environmental moderators of developmental stress. This life-stage transition demands successful cognitive-behavioral recalibration. Therapeutic interventions should promote developmental reappraisal - reframing age-related changes as normative life-cycle transitions while fostering social participation. Public health strategies must address both structural determinants (education, healthcare access) and psychological adaptation mechanisms to disrupt depression pathways in aging populations.\u003c/p\u003e \u003cp\u003eOur findings reveal intergenerational relational deficits (emotional, functional, and communicative) as significant predictors of geriatric depression, with social engagement failing to compensate for family estrangement effects. Family systems theory elucidates this phenomenon through its emphasis on relational homeostasis - psychological distress in older adults often manifests systemic dysfunctions within kinship networks rather than individual pathology.\u003csup\u003e28\u003c/sup\u003e The widening gap between filial expectations shaped by traditional caregiving norms and contemporary intergenerational realities creates developmental mismatch, particularly evident in urbanizing Chinese families experiencing intergenerational contract imbalances.\u003csup\u003e29\u003c/sup\u003e Our analysis identifies social participation as a psychosocial buffering mechanism that partially mitigates - but cannot fully substitute - the mental health consequences of intergenerational estrangement. While engagement in social-recreational activities demonstrates depression-reduction effects through dual pathways of self-actualization and social embeddedness,\u003csup\u003e30,31\u003c/sup\u003e its compensatory capacity remains constrained by the irreplaceable nature of familial emotional bonds. This partial efficacy aligns with social participation theory's emphasis on multidimensional engagement, where voluntary work and intergenerational mentoring emerge as particularly effective buffers against aging-related anomie.\u003csup\u003e12,32\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThese findings necessitate multilevel policy innovations: 1) Developing adaptive employment frameworks that harness older adults' human capital through phased retirement systems; 2) Creating hybrid care models integrating family support with community-based engagement platforms; 3) Implementing age-friendly urban designs that reduce physical barriers to social participation. Crucially, recent empirical work demonstrates that such structural interventions can increase older adults' positive affect while reducing caregiving pressures on younger generations.\u003c/p\u003e \u003cp\u003eStrengths and Limitations: Our findings should be interpreted within methodological and cultural contexts. The nationally representative data enhance ecological validity in examining social participation's mediating role between intergenerational dynamics and late-life depression. However, the observational design inherently limits causal inference, with potential residual confounding from unmeasured variables (e.g., childhood adversity, marital quality). Cross-cultural measurement limitations emerge in depression assessment, where sociocultural desirability biases may underreport symptoms, particularly among male and rural-dwelling elders. Future investigations should employ mixed-methods approaches combining actigraphy-measured social engagement with dyadic family assessments. Policy piloting of intergenerational co-participation programs could simultaneously test intervention efficacy while addressing ageism stigma. These advancements would strengthen both the scientific understanding and practical implementation of relational health paradigms in aging populations.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eOur study looked at the impact of intergenerational family relationships on depression in older adults and tapped into the role of social engagement in this context. There is heterogeneity in the effects of different types of intergenerational family relationships on the mental health of older adults, and estranged family relationships increase the risk of depression in older adults. Although social engagement can alleviate depression to a certain extent, it cannot completely replace family intergenerational ties in helping older adults' mental health.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eIS model: Intergenerational solidarity model\u003c/p\u003e\n\u003cp\u003eIADL: Instrumental Activities of Daily Living\u003c/p\u003e\n\u003cp\u003eBADL: Basic Activities of Daily Living\u003c/p\u003e\n\u003cp\u003eTK: Tight-Knit type (Co-resident/proximal families with strong multidimensional solidarity )\u003c/p\u003e\n\u003cp\u003eAC: Alienation-Close type (Geographically proximate but emotionally/functionally detached)\u003c/p\u003e\n\u003cp\u003eSD: Support-Distant type (Geographically distant yet maintaining functional/emotional ties)\u003c/p\u003e\n\u003cp\u003eDT: Detached type (Distant across all dimensions)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e[Ethics approval and consent to participate]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used in this study were obtained from the publicly available Chinese Longitudinal Healthy Longevity Survey (CLHLS). The original CLHLS protocol was reviewed and approved by the institutional review boards of Peking University , with all participants or their proxies providing signed informed consent. As this study involved only secondary analysis of anonymized data from this established database, no additional ethics approval was required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Consent for publication]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Availability of data and materials]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data supporting this study are available from the Chinese LongitudinalHealthy Longevity Survey (CLHLS) team upon application. Processed datasets generated during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Competing Interests]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Funding]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the National Key Research and Development Program of China (grant number 2022YFC3603004), the Social Science Foundation of Fujian Province (grant number FJ2022C047) and the Xiang'an Innovation Lab Incubation Programme of Xiamen (grant number 2023XAKJ0101032).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Authors' contributions]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLWZ conceptualised the research design, analysed and discussed the data, and reviewed and revised the paper. XYW conceptualised the research questions, analysed the data, discussed the results, and reviewed and revised the paper. ZWZ collated and analysed the data, and was responsible for drafting the first draft of the paper. YF co-ordinated the overall research design, participated in the interpretation of the results, and reviewed and revised the paper. All authors certify that they have no affiliations with or involvement in any organization or entitywith any financial interest or non-financial interest in the subject matter or materials discussed inthis manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[Acknowledgements]\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to the National Key Research and Development Program of China, the Social Science Foundation of Fujian Province and the Xiang'an Innovation Lab Incubation Programme of Xiamen for their support and to all the teachers and students at the Centre for Health Economics and Policy Research, Xiamen University for their help.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBengtson VL, Roberts REL. Intergenerational Solidarity in Aging Families: An Example of Formal Theory Construction. J Marriage Family. 1991;53:856\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCole JC, Rabin AS, Smith TL, Kaufman AS. Development and validation of a Rasch-derived CES-D short form. Psychol Assess. 2004;16:360\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFingerman KL, Zhou Z, Gao S. Intergenerational ties in late life. Curr Opin Psychol. 2024;55:101743.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrase RT, Bauldry S, Suitor JJ, Gilligan M, Ogle D. Adult Children's Education and Mothers' Psychological Well-Being: Do Adult Children's Problems Mediate This Relationship? Journals Gerontology: Ser B. 2023;78:496\u0026ndash;505.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGong J, Wang G, Wang Y, Chen X, Chen Y, Meng Q, Yang P, Yao Y, Zhao Y. 2022. Nowcasting and forecasting the care needs of the older population in China: analysis of data from the China Health and Retirement Longitudinal Study (CHARLS). The Lancet Public Health 7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHwang W, Kim JH, Brown MT, Silverstein M. Intergenerational solidarity of adult children with parents from emerging to established adulthood. J Fam Psychol. 2023;37:853\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRadloff L, S., The CES-D, Scale A. Self-Report Depression Scale for Research in the General Population. Appl Psychol Meas 1, 385\u0026ndash;401.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScott R, Nadorff D. THE IMPACT OF INTERGENERATIONAL SOLIDARITY ON GRANDPARENT WELL-BEING. Innov Aging. 2023;7:123.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhen Z. Improving the population service system covering the whole population and life cycle. China Popul Sci. 2024;38:3\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStekhoven DJ, B\u0026uuml;hlmann P. MissForest\u0026ndash;non-parametric missing value imputation for mixed-type data. Bioinformatics. 2012;28:112\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTiilikainen E, Sepp\u0026auml;nen M. Lost and unfulfilled relationships behind emotional loneliness in old age. Ageing Soc. 2017;37:1068\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeng X, Li Y. Transition and continuation: A typological study of intergenerational relationships in Chinese families. Chin J Sociol. 2024;10:76\u0026ndash;99.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang X, Silverstein M. Intergenerational Emotional Cohesion and Psychological Well-Being of Older Adults in Rural China: A Moderated Mediation Model of Loneliness and Friendship Ties. J Gerontol B Psychol Sci Soc Sci. 2022;77:525\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMannheim K. The Essentials of Karl Mannheim. Nanjing University; 2002.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMannheim K. Karl Mannheim's Quintessence. Contemporary Academic Prism Translation Series. Nanjing University; 2002.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang WZ, Zhang LW, Fang Y. Research on the relationship between intergenerational relationship patterns in families and depressive symptoms in Chinese elderly. Med Soc. 2024;37:93\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu CP. Social Gerontology. China Renmin University; 1999.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHao SC, Zhou Z, Fang Y. Interaction and combined effects of living arrangements and loneliness on self-rated health of the elderly. Chin J Gerontol. 2016;36:2502\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQue S, Zeng YB, Fang Y. Research on the impact of social participation on cognitive function of Chinese elderly based on fixed effects model. Chin J Health Stat. 2023;40:36\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen JY, Fang Y, Zeng YB. Research on the impact of multiple social participation and family support on mental health of Chinese elderly. Chin J Health Policy. 2021;14:45\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mental health, depressive symptoms, intergenerational relationships, Chinese older adults","lastPublishedDoi":"10.21203/rs.3.rs-6455468/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6455468/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAlthough existing research has linked family intergenerational relationships with psychosocial depressive conditions in older adults, the mechanisms and conditions associated with these relationships remain underexplored. We categorize the main patterns of family intergenerational relationships in China. Further we examined how social engagement moderates the relationship between family intergenerational relationship patterns and depression.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe data were collected from the Chinese Longitudinal Healthy Longevity Survey (2011\u0026ndash;2018, wave 1\u0026ndash;3), which utilized latent class analysis to identify family intergenerational relationship patterns among 9,765 eligible older adults. Generalized linear models were then utilized to explore the influence mechanisms between different intergenerational relationship patterns and geriatric mental health.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eBased on the results of the latent class analysis and the four dimensions of the intergenerational solidarity model (residential distance, connection, emotion, and function), four relationship types were identified: Tight-Knit, Support-Distant, Alienation-Close, and Detached. Generalized linear modeling analysis revealed that detached family intergenerational relationships, education, self-rated health, and self-rated quality of life had significant effects on depressive symptoms in older adults (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Social participation (including recreational and social activities) moderated the relationship between family intergenerational dynamics and depressive symptoms (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Higher levels of social participation notably mitigated the negative impact of detached family intergenerational relationships on depressive symptoms in older adults (\u003cem\u003er\u003c/em\u003e = -0.176, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eDistant family ties heighten depression risk in older adults. Although social involvement can't fully substitute family support, it partially relieves depressive symptoms. As family is society's basic unit and linked to older adults, gaps in family support should encourage engagement in social activities and 'active aging'. This helps them rediscover self-worth and address mental health challenges from strained family ties, ultimately reducing depression risk.\u003c/p\u003e","manuscriptTitle":"Do Intergenerational Bonds Reduce Depression Risk in Aging China? Evidence from a Nationwide Cohort","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-11 16:13:35","doi":"10.21203/rs.3.rs-6455468/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-06-09T04:00:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-04T07:36:28+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-15T10:15:36+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-14T09:55:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Geriatrics","date":"2025-05-14T09:54:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"503987b5-0fe7-4303-a185-85b0e1260c5e","owner":[],"postedDate":"June 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-06-11T16:13:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-11 16:13:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6455468","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6455468","identity":"rs-6455468","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}