Care Dependency and Depressive Symptoms in Middle‐Aged and Older Couples: A Longitudinal Actor–Partner Interdependence Analysis

ABSTRACT Objective This study investigated the mental health of middle‐aged and older Chinese couples following care dependency trajectories. Background Although cross‐sectional studies have investigated the relationship between care dependency and depressive symptoms, longitudinal research examining this relationship and gendered patterns among couples remains limited. Method Group‐based trajectory modeling identified care dependency and depressive symptom trajectories. Multinomial regression examined the relationship between the care dependency trajectories of couples and depressive symptom trajectories of their spouses. Depressive symptoms were compared among couples in which both partners experienced care dependency. Results Three trajectories were identified for care dependency based on both activities of daily living (ADL) and instrumental activities of daily living (IADL) (stable minimal, moderately increasing, and highly increasing) and for depressive symptoms (stable minimal, moderately persistent, and highly persistent). Moderately or highly increasing care dependency trajectories were associated with a higher risk of moderately or highly persistent depressive trajectories, consistently observed for both husbands and wives. Partner effects were more pervasive for IADL‐based care dependency, whereas ADL‐based partner effects were primarily observed in cases with highly increasing trajectories, indicating that cross‐spouse associations differed by functional domain and the severity of trajectory. Conclusion There is a significant association between the trajectories of care dependency and depressive symptoms across waves. Implications Given that the trajectories of care dependency and depressive symptoms mirror one another, interventions and policies should treat the couples as a unit and prioritize support for individuals with ADL‐ and IADL‐based care needs to prevent the adverse mental health consequences of functional decline.