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

Objectives: Depressive symptoms are common among middle-aged and older adults. This study examined the associations of family structure and its transitions with depressive symptoms, and the mediating role of intergenerational support. Methods: Participants were drawn from the first five waves of CHARLS. Family structure and transitions were assessed at baseline (Wave 1) and Wave 2. Outcome was defined as new-onset depressive symptoms occurring after Wave 2 among participants who were free of depressive symptoms at both Wave 1 and Wave 2. A Cox proportional hazards model was used to examine the association between family structure/transitions and incident depressive symptoms. Parallel mediation analysis was conducted to examine the potential mediating effects of intergenerational support. Results: Compared with two-generation households, skipped-generation households were associated with a higher risk of depressive symptoms in older adults (HR = 1.30, 95% CI: 1.04–1.63), and transitions from two-generation to skipped-generation households were also associated with a higher risk (HR = 1.54, 95% CI: 1.06–2.23). Emotional support partially mediated this association. Conclusions: Older adults living in or transitioning to skipped-generation households are associated with a higher risk of depressive symptoms, suggesting that public health efforts should prioritize skipped-generation households and the processes leading to their formation.