Family Functioning, Life Satisfaction, and Depressive Symptoms in Chinese Adults With Diabetes and Hypertension: A Cross‐Lagged Model

This study aims to evaluate the bidirectional relationship between family functioning and depressive symptoms, considering life satisfaction as a potential mediator and gender, age and income as a moderator of these associations. A longitudinal study was conducted with 708 Chinese adults with diabetes and hypertension (51.6% women; mean age: 64.1 ± 7.7 years) recruited from 12 community health services. Data were collected at baseline (T1), one-year follow-up (T2), and two-year follow-up (T3) using self-reported assessments of family functioning, depressive symptoms, and life satisfaction. Depressive symptoms negatively predicted family functioning from T1 to T2, and family functioning negatively predicted depressive symptoms from T2 to T3. Furthermore, life satisfaction mediated the relationship between family functioning and depressive symptoms from T1 to T3, and vice versa. Differences in gender, age, and income showed distinct patterns. Life satisfaction at T2 mediated the effect of family functioning at T1 on depressive symptoms at T3 for men, women, middle-aged and low-income adults, whereas life satisfaction mediated the effect of depressive symptoms at T1 on family functioning at T3 only among women and low-income adults. This study explores the relationships among family functioning, life satisfaction, and depressive symptoms, noting potential differences based on gender, age and income. Family-level interventions targeting life satisfaction could a helpful approach to addressing depressive symptoms among Chinese adults aged 45 and older with type 2 diabetes and/or hypertension.