The impact of grandchild care on depressive symptoms of grandparents in China: The mediating effects of generational support from children

Association of the intergenerational structure with the onset of depressive symptoms among middle-aged and older adults in China

BACKGROUND

Chinese family structure has undergone tremendous changes over the past few decades. Moreover, the association of the intergenerational structure with depression remains controversial.

AIMS

This study aimed to find out the association of the intergenerational structure and the onset of depressive symptoms among Chinese middle-aged and older adults.

METHODS

This study included 4,868 participants of the China Health and Retirement Longitudinal Study (CHARLS), who were enrolled in 2011 without depressive symptoms and followed up at least once later in 2013, 2015, 2018, and 2020. Taking the time-varying confounding effect into account, the time-dependent Cox regression models were used to estimate the association of the intergenerational structure and the onset of depressive symptoms.

RESULTS

Among the studied middle-aged and older adults, compared to one-generation households, higher hazard ratios (HR) of developing depressive symptoms were found in three-generation households in the study population (HR = 1.21, 95% CI [1.08, 1.36]). Further, for female participants, skipping-generation households (HR = 1.38, 95% CI [1.05, 1.83]) and three-generation lineal households (HR = 1.21, 95% CI [1.02, 1.43]) were found to be significantly associated with new-onset depressive symptoms compared to empty-nest couples. For male participants, living alone (HR = 1.65, 95% CI [1.30, 2.11]), living in standardized nuclear households (HR = 1.27, 95% CI [1.06, 1.54]), impaired nuclear households (HR = 1.80, 95% CI [1.18, 2.76]), or three-generation lineal households (HR = 1.34, 95% CI [1.12, 1.60]) were found to have a significant association with the onset of depressive symptoms.

CONCLUSIONS

This study found that males living alone, with unmarried children, or in three-generation lineal households, and females living with grandchildren were more likely to suffer from depressive symptoms. Therefore, special attention should be paid to people in these intergenerational structure subtypes.

Intrinsic capacity trajectories, predictors and associations with care dependence in community-dwelling older adults: A social determinant of health perspective

AIMS

To identify intrinsic capacity trajectories, predictors of intrinsic capacity trajectories and associations between intrinsic capacity trajectories and care dependence in community-dwelling older adults in China.

METHODS

A retrospective longitudinal study was conducted, and the data were obtained from a five-year national longitudinal cohort study of older adults in China between 2011 and 2015. The social determinants of health framework informed the data analysis and interpretation.

RESULTS

A total of 3893 older adults met the selection criteria and were included in the study. Three intrinsic capacity trajectories were identified: high trajectory (15.7 %), stable trajectory (52.7 %) and declining trajectory (31.6 %). Social determinants contribute to intrinsic capacity decline in older adults. Decreased cognitive function, psychological status, and locomotion at baseline were associated with care dependence.

CONCLUSION

Approximately thirty percent of the older adults in this cohort study experienced a decline in intrinsic capacity within a 5-year period. Social determinants contributed to this decline in older adults.

Grandparenting and life satisfaction among Chinese elderlies: a study of possible mechanisms

OBJECTIVE

This study examines the impact of caregiving on older people's life satisfaction, focusing on the role of caring for grandchildren. The study considers individual characteristics (aging attitudes) and situational factors (intergenerational support) and aims to identify the mediating roles of aging attitudes and intergenerational support in the relationship between caregiving and life satisfaction.

METHOD

The study analyzed data from the 2014 China Longitudinal Aging Social Survey (CLASS), focusing on 5363 grandparents who reported providing care for their grandchildren in the 12 months before the survey. Life satisfaction was subjectively measured. The data was analyzed using multiple linear regression, propensity score matching, and mediation analysis.

RESULT

The study found that grandparents who cared for their grandchildren have higher levels of life satisfaction. Self-aging attitudes, general aging attitudes, intergenerational economic support, intergenerational instrumental support, and intergenerational emotional support fully mediated the relationship between grandchild care and life satisfaction.

CONCLUSION

This study demonstrates that caring for grandchildren is a vital activity for older people that helps them develop positive aging attitudes and strengthens intergenerational support, thereby improving their quality of life. Hence, the government, society, families, and communities should provide more social support to older adults caring for grandchildren. This would not only benefit the health of the older people themselves but also promote intergenerational harmony and family development.

Impacts of grandparenting on older Chinese adults' mental health: a cross-sectional study

BACKGROUND

The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support.

METHODS

Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80.

RESULTS

After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided.

CONCLUSION

Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided.

Continuity and changes in grandchild care and the risk of depression for Chinese grandparents: new evidence from CHARLS

Objectives

Although studies have researched the mental effects of intergenerational care, little is known about the impact of transformations in caregiving intensity on depression. This study explores grand-parents' depressive symptom outcomes in terms of changes over time in grandparental childcare, with considerations for subgroup differences.

Method

Using data from the 2015-2018 China Health and Retirement Longitudinal Study on grandparents aged 45 and older, we adopted generalized estimating equations to estimate the effects of seven category changes [(1) continued to provide high-intensity or (2) low-intensity care at both waves; (3) never provided care; (4) started caregiving; (5) ended caregiving; (6) provided less intensive care; and (7) provided more intensive care] over time in grandparental childcare on depressive symptoms among 17,701 grandparents with at least one grandchild, as well as how the impact varies by gender and urban/rural areas.

Results

Grandparents who decreased the intensity of care, stopped childcare, or offered continuous low-intensity care were associated with a lower level of depression compared with those providing no childcare. In addition, the benefit of continuous caregiving on mental health was especially noticeable in urban grandmothers.

Conclusion

Providing continuous low-intensity, decreased-intensity grandparenting and the cessation of caregiving were associated with a decreased level of depression for Chinese grandparents; however, there were complex interactions at play. Policies aimed at supporting grandparenting should consider caregiving intensity transitions relevant to gender and urban/rural residence.