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Configurational effects of intergenerational support on older adults鈥� depression: an empirical study from CHARLS data

成人头条 volume听25, Article听number:听392 (2025) Cite this article

Abstract

Background

The influence of different dimensions of intergenerational support on depression in older adults has a configuration effect. Existing researches have only used linear analyses to examine the independent effects of each dimension of intergenerational support on depression in older adults, resulting in the nature of the effects of each dimension of intergenerational support on the presence of depression in older adults remaining highly controversial.

Objective

To explore the synergy and substitution effects (configurational effects) of dimensions of intergenerational support on depression in older adults.

Method

Based on data from the 2018 China Health and Retirement Longitudinal Study(CHARLS), depression among older adults was used as the outcome variable, and intergenerational support (including three dimensions of emotional, economic, and caregiving support) was used as the antecedent variable. Qualitative comparative analysis (QCA) was used to analyze the configurational effects of intergenerational support on depression in older adults.

Result

A single dimension of intergenerational support cannot be a necessary condition for depression in older adults.Factor configurations of different dimensions of intergenerational support as a sufficient condition for depression in older adults. The consistency parameter for all solution configurations in this study is 0.83, with a coverage of 0.61. The research identifies four types of configurational patterns associated with older adults鈥� depression: 鈥淯nidirectional Care Deficiency Type鈥� (consistency mean of 0.84, coverage of 0.49), 鈥淏idirectional Care Deficiency Type鈥� (consistency mean of 0.86, coverage of 0.33), 鈥淏idirectional Economic Deficiency Type鈥� (consistency mean of 0.85, coverage of 0.48), and 鈥淢ixed Type鈥� (consistency mean of 0.83, coverage of 0.23).

Conclusion

Depression in older adults is influenced by the configurational effects of intergenerational support. The complex link between intergenerational support and depression in older adults should be examined from a holistic perspective, paying attention to the dynamic balance of intergenerational support reception and provision.

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Introduction

In recent years, the mental health issues of the older adults have gained widespread attention, with depression being one of the primary psychological health concerns among the older adult population [1, 2]. Depression not only has adverse effects on their physical health but also contributes to increased mortality rates [3]. In China, where the family-based elderly care model predominates, intergenerational support plays a crucial role in the psychological well-being of the older adults [4, 5]. Amid the ongoing process of healthy aging, exploring the impact of intergenerational support on older adults鈥� depression is essential for achieving successful aging with good health.

Effects of intergenerational support across different dimensions on older adults鈥� depression

Intergenerational support primarily refers to the mutual assistance between older adults and their adult children, which can be categorized into three dimensions: emotional support, economic support, and caregiving support [6, 7]. Many studies have shown that depression in older adults is influenced by these three dimensions of intergenerational support [8, 9], but the nature of their impact on depression in older adults remains controversial [10]. In the dimension of emotional support, numerous studies have indicated that emotional support between older adults and their adult children contributes to alleviating depressive symptoms and promoting their mental well-being [11, 12]. However, Krsteska et al. argue that excessively frequent emotional support can lead to conflicts, resulting in decreased subjective well-being and increased levels of depression among the older adults [13]. In the dimension of economic support, many researchers contend that the impact of older adults receiving or providing economic support on their depression is influenced by factors such as age, rural or urban residence, and gender.For instance, Cong Z et al. suggested that receiving economic support from adult children satisfies the daily living and healthcare needs of older adults in rural areas, thereby contributing to an improvement in their psychological well-being [14, 15]. Research by Li et al. indicated that providing economic support can significantly alleviate depressive symptoms in male older adults, but it doesn鈥檛 show significant effects on female older adults [16]. Regarding the impact of caregiving support on older adults鈥� depression, there are mainly three viewpoints: [1] Receiving caregiving support contributes to the enhancement of the psychological well-being of older adults [17]; [2] Receiving excessive caregiving support might lead to an overdependence on adult children, accelerating their physical and mental health decline and increasing depressive levels [18, 19]; [3] Caregiving support may not exhibit a significant relationship with the psychological well-being of older adults [20].

Research methods on the relationship between intergenerational support and older adults鈥� Depression

Currently, scholars mainly use linear research methods such as regression analysis and structural equation modeling to explore the relationship between intergenerational support and depression in older adults. However, their findings are somewhat controversial, possibly due to the limitations of linear research methods in exploring configurational factors [21, 22]. For example, Sun et al.鈥榮 [23]findings using regression analysis indicated that emotional support was negatively associated with depression in older adults, while economic support and caregiving support did not have a significant effect. Shu et al.鈥榮 [24]findings using structural equation modeling indicated that emotional support and caregiving support were negatively associated with depression in older adults, and economic support was positively associated with depression in older adults. The above studies assume some type of linear relationship between intergenerational support and depression in older adults, while ignoring the nonlinear associations that exist between the two. In fact, older adults are exposed to multiple dimensions of intergenerational support at the same time, and there may be a 鈥渃lustering鈥� effect of their impact on depression in older adults [25, 26]. There may be a nonlinear 鈥渃hain of equivalent causality鈥� in which multiple dimensions of intergenerational support interactions combine to cause depression in older adults, i.e., a configurational effect of intergenerational support interactions on depression in older adults. However, relevant studies have not focused on this issue, so it is necessary to explore the effects of intergenerational support configuration effects on depression in older adults, which will deepen the understanding of the mechanism of depression in older adults.

Research review

Although previous linear studies have been able to analyze the independent effects of different dimensions of intergenerational support on depression in older adults on a case-by-case basis and to portray the way in which the independent variable acts on the dependent variable through mediating and moderating variables [23]. But their essence lies in explaining the variability of the dependent variable through the substitution and accumulation of independent variables [27]. The relationships between variables are not necessarily equivalent [28], making it insufficient to explain the configurational effects of intergenerational support on older adults鈥� depression from a holistic perspective.

This study used qualitative comparative analysis (QCA) approach to explore the impact of the configurational effects of intergenerational support on depression in older adults. This compensates for the limitations of the singular perspective offered by linear research methods, providing a new approach to understanding the impact of intergenerational support on older adults鈥� depression [29, 30]. Furthermore, the QCA method can reveal the equifinality relationships between different configurations of factors and older adults鈥� depression [31]. This is highly suitable for explaining the configurational effects of intergenerational support on older adults鈥� depression, aiding in a more comprehensive understanding of the intricate relationship between intergenerational support and older adults鈥� depression.

Research principle

At present, there are no studies focusing on the configuration effect of intergenerational support on depression in older adults. This study assumes that the influence of intergenerational support on depression in older adults is not independent of each other, but forms a combination of factors to jointly affect depression in older adults. This study used different indicators to measure intergenerational support. Emotional support was measured using two indicators, 鈥渕eeting with children鈥� and " distant communication with children鈥�, to measure the communication and interaction between older adults and their children at the mental and emotional levels. Economic support uses the indicators 鈥渞eceiving economic support鈥� and 鈥減roviding economic support鈥� to measure the financial assistance (both cash and non-cash) received or provided by older adults. For caregiving support, the indicators 鈥渞eceiving caregiving support鈥� and 鈥減roviding caregiving support鈥� are used to measure the receipt or provision of life-level help and care for older adults [9, 32]. The relationship between the configurational effects of intergenerational support and depression in older adults is shown in Fig.听1.

Fig. 1
figure 1

Configurational effects of intergenerational support on depression in older adults

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Data source and measurement

Data source

The data for this study is obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS). CHARLS is a large interdisciplinary survey project led by the National School of Development at Peking University. In 2018, the survey employed a stratified random sampling method to conduct questionnaire surveys in 150 counties and 450 communities (or villages) across 28 provinces, autonomous regions, and municipalities in China. A total of 19,816 participants aged 45 and above were surveyed in this study. After excluding samples under 60 years of age (n鈥�=鈥�8998) and samples with missing antecedent and outcome variables (n鈥�=鈥�4187), 6631 samples were obtained.

Data measurement

Outcome variable

The outcome variable of this study is older adults鈥� depression. The CHARLS survey utilizes the abbreviated Center for Epidemiologic Studies Depression Scale (CES-D-10) to assess the depressive symptoms among older adults. This scale has demonstrated sufficient reliability and validity [33, 34].The CES-D-10 consists of a total of 10 items, with eight items assessing negative emotions and two items assessing positive emotions.Responses to the 10 items are scored in the same way, ranging from positive to negative with values assigned as 0, 1, 2, and 3. The scores of the 10 items are summed up, and a total score of 鈮モ��10 indicates depression, assigned a value of 鈥�1鈥�; a total score of <鈥�10 indicates no depression, assigned a value of 鈥�0鈥� [35]. The sample was divided into a depressive sample (2378, 35.85%) and a non-depressive sample (4253, 64.14%) for backup. Depression related questions are shown in Table听1.

Table 1 Depression related questions
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Antecedent variable

Emotional Support:鈥淢eeting with children鈥� and 鈥淒istant Communication with Children鈥� are measured based on the frequency of interaction between the older adults and their adult children. Responses are scored on a scale from 1 to 9. The scores for each dimension are summed up for each sample, resulting in a total score representing the measurement of intergenerational emotional support. A higher score indicates a closer emotional bond between generations [32].

Economic Support:鈥淩eceiving Economic Support鈥� is measured by the total amount of money or goods received by the older adults from their adult children. 鈥淧roviding Economic Support鈥� is measured by the total amount of money or goods provided by the older adults to their adult children [32].

Caregiving Support:鈥淩eceiving Caregiving Support鈥� is measured as a binary variable indicating whether the older adults receive caregiving support from their adult children.鈥淧roviding Caregiving Support鈥� is measured as a binary variable indicating whether the older adults provide caregiving support to their adult children [36].Variable names and assignment methods are shown in Table听2.

Table 2 Antecedent variables
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Research method

Unlike traditional linear analysis that aims to explore the linear relationship between the independent effects of the independent variables and the dependent variable, qualitative comparative analysis (QCA) is based on set theory and analyzes the nonlinear relationship between the interactions and combinations of multiple influences and the outcome variable from a grouping perspective [37], i.e., the configurational effect.With the development of QCA, it is not only applicable to case studies with dozens of samples, but also to studies with hundreds or even thousands of sample data [31, 38]. In large-sample QCA studies, the rationing of the samples needs to be met with a proportion of samples that are consistent with the interpreted results (depressed samples) of about 80% [39] and a proportion of samples that are inconsistent with the interpreted results (non-depressed samples) of about 20%.

In this study, all depressed samples (a total of 2973 older adults) were included in the analysis, accounting for 80% of the analysis samples. Under the premise of not changing the homogeneity of the research samples, QCA research can adopt the methods of theoretical sampling and purpose sampling to process the data [38]. In this study, the non-depressed sample was randomly sampled [40], and a total of 595 samples were taken, which constituted 20% of the analysis sample. Among the samples included in the analysis, 2378 were depressed (80%) and 595 were not depressed (20%).

Calibration of data

In Qualitative Comparative Analysis (QCA), each predictor and outcome variable is treated as an independent set, and each sample is assigned membership scores within these sets. The process of assigning membership scores to each sample within these sets is called calibration [41]. According to the calibration criteria of Fiss [31] and the reality of the sample data. The three binary variables 鈥渄epression鈥�, 鈥渞eceiving caregiving support鈥� and 鈥減roviding caregiving support鈥� were calibrated to 1 for full affiliation and 0 for full non-affiliation. For the 鈥渕eeting with children鈥�, 鈥渄istant communication with children鈥�, 鈥渞eceiving economic support鈥�, and 鈥減roviding economic support鈥�, the four continuous variables were calibrated by choosing three anchors of 0.9 (full affiliation), mean (crossover point), and 0.1 (full non-affiliation) [42].The calibration information for each variable is shown in Table听3.

Table 3 Variable calibration
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Data analysis and empirical results

Necessity condition analysis

Prior to conducting configurational analysis, it is essential to examine whether single-dimensional intergenerational support (including its negations) constitutes a necessary condition for older adults鈥� depression. In QCA research, when an outcome occurs, if a particular factor is consistently present, that factor constitutes a necessary condition for the outcome variable [42]. The critical criterion to assess the existence of a necessary condition is the consistency parameter, with a value exceeding 0.9 indicating that the factor is necessary for the outcome [41].

Table听4 presents the results of the necessary condition tests for older adults鈥� depression and non-depression using the fsQCA 3.0 software. It is evident that the consistency levels for all causal factors are less than 0.9. As a result, single-dimensional intergenerational support does not constitute a necessary condition for either the presence or absence of older adults鈥� depression.

Table 4 Necessity condition analysis
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Sufficiency condition analysis for older adults鈥� depression

In this study, the fsQCA 3.0 software was used to analyze the adequacy conditions for depression in older adults, and the consistency threshold was set at 0.85 to ensure that the identified factor configurations were reliable predictors of the outcome variables [43]. The PRI consistency was set to 0.8, designed to ensure that factor configurations were at least 80% robust in otherwise similar situations [44]; the frequency threshold was set to 3, to exclude factor configurations by chance [44]. The factor configurations affecting depression in older adults are shown in Table听5.

Each column represents a factor configuration that can be used to explain older adults鈥� depression. The overall consistency of all solution sets is 0.83, indicating that there is an 83% probability that older adults鈥� depression is explained by these 10 factor configurations. The coverage of solutions is 0.61, meaning that 61% of the total depressed samples can be explained by these 10 factor configurations. Both the consistency and coverage of solutions surpass the critical thresholds, affirming the effectiveness of the empirical analysis. Based on the similarity of configurational patterns, this study categorizes them into four types: Unidirectional Caregiving Deficit, Bidirectional Caregiving Deficit, Bidirectional Economic Deficit, and Mixed Type.

Table 5 Configuration of factors of depression in older adults
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鈥淯nidirectional caregiving Deficit鈥� configurational pattern

The most important feature of the鈥淯nidirectional Caregiving Deficit鈥漟actor configuration is the lack of caregiving support from children to parents, and it contains subtypes A1, A2, and A3.Subtype A1 involves the absence of both core influencing factors, 鈥減roviding economic support鈥� and 鈥渞eceiving caregiving support.鈥� It was indicated that a core element contributing to depression in the older adults is the absence of economic and caregiving support from the children to the parents.SubtypeA 2 features the presence of the core influencing factor 鈥渕eeting with children鈥� and the absence of the core influencing factor 鈥渞eceiving caregiving support,鈥� alongside the absence of the marginal influencing factor 鈥渄istant contact with children.鈥� It was indicated that the core element contributing to depression in older adults was that children saw their parents frequently and did not provide caregiving support for them, and the non-core element was that children lacked distant contact with their parents (seeing them frequently, with a consequent decrease in the number of distant contacts). Subtype A3 comprises the presence of the core influencing factor 鈥渕eeting with children,鈥� the absence of the core influencing factor 鈥渞eceiving caregiving support,鈥� and the presence of the marginal influencing factor 鈥渞eceiving economic support.鈥� The core elements indicated as contributing to depression in older adults were children seeing their parents frequently and not providing caregiving support for them, and the non-core element was parents receiving economic support from their children.The average consistency level of the 鈥淯nidirectional Caregiving Deficit鈥� configurational pattern is 0.84, indicating an 84% probability of older adults鈥� depression being explained by this pattern. The coverage is 0.49, indicating that this pattern accounts for 49% of the total depressed sample.

鈥淏idirectional caregiving Deficit鈥� configurational pattern

The most important feature of the factor configuration 鈥淏idirectional Caregiving Deficit鈥漣s that parents do not provide caregiving support for their children and do not receive caregiving support from their children, and it contains subtypes B1 and B2. Subtype B1 involves the absence of both core influencing factors, 鈥減roviding and receiving caregiving support,鈥� along with the absence of the marginal influencing factor 鈥渞eceiving economic support.鈥� The core element that was indicated as contributing to depression in older adults was the lack of caregiving support for each other from both children and parents, and the non-core element was the failure of parents to receive economic support from their children.Subtype B2 features the absence of both core influencing factors, 鈥減roviding and receiving caregiving support,鈥� as well as the absence of the marginal influencing factor 鈥渄istant contact with children.鈥� It was indicated that the core element contributing to depression in older adults was the lack of caregiving support provided to each other by both children and parents, and the non-core element was the lack of remote contact between children and their parents.The average consistency level of the 鈥淏idirectional Caregiving Deficit鈥� configurational pattern is 0.86, implying an 86% probability of older adults鈥� depression being explained by this pattern. The coverage is 0.33, indicating that this pattern accounts for 33% of the total depressed sample.

鈥淏idirectional economic Deficit鈥� configurational pattern

The most important feature of the factor grouping 鈥淏idirectional Economic Deficit鈥� is the fact that parents do not provide economic support to their children and do not receive economic support from them, and it contains subtypes C1 and C2. Subtype C1 involves the absence of four core influencing factors: 鈥渕eeting with children,鈥� 鈥渞eceiving and providing economic support,鈥� and 鈥減roviding caregiving support.鈥� It was indicated that the core elements contributing to depression in older adults were that children did not see their parents regularly, that neither party provided economic support for the other, and that parents did not provide caregiving support for their children.Subtype C2 features the absence of three core influencing factors: 鈥渕eeting with children,鈥� 鈥渞eceiving and providing economic support,鈥� and the presence of the core influencing factor 鈥渄istant contact with children.鈥� The core elements indicated as contributing to depression in older adults are that children do not see their parents regularly, neither party provides economic support for the other, and children maintain distant contact with their parents.The average consistency level of the 鈥淏idirectional Economic Deficit鈥� configurational pattern is 0.85, indicating an 85% probability of older adults鈥� depression being explained by this pattern. The coverage is 0.48, indicating that this pattern accounts for 48% of the total depressed sample.

鈥淢ixed鈥� configurational pattern

The most important feature of the 鈥淢ixed鈥� factor configuration is that it involves multiple combinations of different dimensions of intergenerational support, and it contains subtypes D1, D2, and D3. Subtype D1 includes the presence of the core influencing factors 鈥渕eeting with children鈥� and 鈥渄istant contact with children,鈥� alongside the absence of the core influencing factors 鈥渞eceiving economic support鈥� and 鈥減roviding caregiving support.鈥� It was indicated that the core elements contributing to depression among older adults were the presence of children who saw their parents regularly, or who were in distant contact with their parents, and the fact that parents did not receive economic support from their children and did not provide caregiving support for their children.Subtype D2 features the presence of the core influencing factors 鈥渄istant contact with children鈥� and 鈥渞eceiving economic support,鈥� as well as the absence of the core influencing factor 鈥渞eceiving caregiving support鈥� and the presence of the marginal influencing factor 鈥減roviding caregiving support.鈥� Indicates that the core elements contributing to depression in older adults are parents who are remotely connected with their children, receive economic support from their children and do not receive caregiving support from their children, and the non-core element is parents providing caregiving support to their children.Subtype D3 involves the absence of the core influencing factors 鈥渕eeting with children鈥� and 鈥減roviding caregiving support,鈥� the presence of the core influencing factors 鈥渄istant contact with children鈥� and 鈥渞eceiving economic support,鈥� and the presence of the marginal influencing factor 鈥渞eceiving caregiving support.鈥� Indicated that the core elements contributing to depression in older adults were that parents did not see their children regularly and did not provide caregiving support to their children, that parents were in distant contact with their children and received economic support from their children, and that the non-core element was the receipt of caregiving support from their children.The average consistency level of the 鈥淢ixed鈥� configurational pattern is 0.83, indicating an 83% probability of older adults鈥� depression being explained by this pattern. The coverage is 0.23, indicating that this pattern accounts for 23% of the total depressed sample.

Discussion

Unlike existing studies that have primarily used linear analysis to explore the independent effects of intergenerational support on older adult depression, the present study utilized a QCA approach to explore the influence of intergenerational support configuration effects on older adult depression. The inability of traditional linear methods to analyze the configurational effects of multidimensional intergenerational support on older adult depression has been addressed [45], helping to deepen the understanding of the relationship between intergenerational support and older adult depression.

Single-dimensional intergenerational support does not constitute a necessary condition for depression in older adults

The present study found that a single dimension of intergenerational support does not constitute a necessary condition for depression in older adults, i.e., multidimensional intergenerational support collectively influences depression in older adults, rather than a single independent factor. The 10 sets of intergenerational support configurations affecting depression in older adults identified in this study involve different dimensions of intergenerational support, predicting synergistic or substitutive effects of different dimensions of intergenerational support. This is similar to the 鈥渃lustering鈥� effect of multidimensional intergenerational support on depression in older adults that has been found in previous studies [25, 26]. However, this study reveals the substitution effect of different dimensions of intergenerational support to a certain extent.

Impact of the 鈥淯nidirectional care Deficit鈥� configuration on older adults鈥� depression

The 鈥淯nidirectional Care Deficit鈥� configuration indicates that the absence of 鈥渞eceiving caregiving support鈥� and its interaction with different types of emotional and economic support collectively contribute to an increased risk of older adults鈥� depression. Subtype A1 can be explained as follows: In intergenerational exchange relationships, the older adults tend to become the providers of economic support, which contributes to an enhancement of their self-worth [16]. Additionally, as the older adults aging, their physical well-being tends to decline, receiving caregiving support from their children can help mitigate the decline in their overall health [17]. Therefore, when older adults are unable to provide economic support and do not receive caregiving support, their self-esteem and independence may be undermined [46]. This situation can lead to a sense of 鈥渓ack of support in old age鈥� and an increased risk of depression.

SubtypeA 2 and SubtypeA 3 can be explained as follows: When the older adults live together with their children or reside in close proximity, but still do not receive caregiving support from their children, it indicates the possibility of some kind of conflict or tension between them. Koelmel and others have suggested that when older adults receive caregiving support from their children and maintain positive intergenerational relationships, it can reduce psychological distress and alleviate levels of depression [17]. However, in the context of Subtypes 2 and 3, the conflictual intergenerational relationships between the older adults and their children may diminish the former鈥檚 subjective well-being [47]. Moreover, the absence of caregiving support from children can intensify negative emotions such as sadness and distress, subsequently increasing the level of depression.

Impact of the 鈥淏idirectional care Deficit鈥� configuration on older adults鈥檇epression

The 鈥淏idirectional Care Deficit鈥� configurational pattern reflects the importance of both receiving and providing caregiving support for the psychological well-being of older adults. Scholars like Lowenstein suggest that mutual caregiving support between the older adults and their children contributes to the mental health of both parties [48]. Research by Merril and others indicates that in three-generation households (consisting of older adultparents, adult children, and grandchildren), older adults who receive caregiving support from their children experience increased subjective well-being. Simultaneously, older adults also find a sense of fulfillment in providing caregiving support [49]. In the context of the 鈥淏idirectional Care Deficit鈥� configurational pattern, the reduced level of social engagement for older adults [50] may coincide with the added burden of self-care responsibilities. As a result, their depression levels may increase.

Impact of the 鈥淏idirectional economic Deficit鈥� configuration on older adults鈥檇epression

The 鈥淏idirectional Economic Deficit鈥� configurational pattern reveals that the absence of both 鈥渞eceiving and providing economic support鈥� and its interaction with emotional and caregiving support collectively contribute to an increased risk of depression among older adults. Subtype C1 can be interpreted as follows: as older adults experience a decline in economic resources and labor capacity, they may become unable to provide economic and caregiving support to their children, leading to a decrease in their sense of self-efficacy [51]. Additionally, the lack of economic support from their children can negatively impact the material quality of life for older adults. Coupled with the absence of in-person contact with their children, this situation can exacerbate feelings of depression among the older adults. Subtype 7 reflects a scenario in which older adults rely solely on distant contact to maintain intergenerational emotional connections. Such a situation can be a risk factor for depression among the older adults [52]. Furthermore, when older adults neither receive nor provide economic support [53], they may worry about their own economic pressures, particularly when facing financial constraints in their lives. Under the influence of Subtypes C1 and C2, older adults are not only confronted with economic pressures but also experience strained intergenerational emotional relationships and a lack of caregiving support. These combined factors contribute to an elevated level of depression among the older adults.

The impact of the 鈥淢ixed Type鈥� configuration on depression in the older adults

The 鈥淢ixed Type鈥� configuration underscores the combined effects of intergenerational support from different dimensions on depression in the older adults. Subtype D1 can be explained as follows: Even when emotional communication exists between the older adults and their children, they still have to grapple with economic pressures in their daily lives. Moreover, as they aging, feelings of inability to provide caregiving support to their children may arise, leading to a sense of disappointment [49]. Subtype D2 can be understood in the context of families where children work away from home. The older adults in such situations maintain remote communication with their children, receive financial support, and shoulder the responsibility of household caregiving. However, the absence of actual caregiving support runs counter to the traditional values of children caring for their older parents. Subtype D3 illustrates that some older adults may not live with their children and primarily maintain emotional connections through remote means. These older adults do not contribute caregiving support to their children and also rely on their children for financial support. This suggests that older adults, without a heightened sense of self-worth, may still worry about becoming a burden to their children [54]. In general, the 鈥淢ixed Type鈥� configuration indicates that the unrestricted combination of intergenerational support from different dimensions can lead to an increase in depression levels among the older adults.

Conclusion and future directions

Based on data from the China Health and Retirement Longitudinal Study (CHARLS), this study utilized qualitative comparative analysis (QCA) to investigate the effects of intergenerational support factor configurations on older adult depression.The study findings are summarized as follows: [1]Single-dimensional intergenerational support does not constitute a necessary condition for influencing depression among the older adults [2]. Configurations of intergenerational support across different dimensions are sufficient conditions for depression among the older adults. The study achieved a consistency level of 0.83 and a coverage of 0.61 for all samples [3]. The study identifies four types of configurations contributing to depression among the older adults:鈥淯nidirectional Care Deficit鈥� characterized by the absence of receiving caregiving support as the primary feature. It has an average consistency of 0.84 and a coverage of 0.49.鈥淏idirectional Economic Deficit鈥� characterized by the absence of both receiving and providing caregiving support. It has an average consistency of 0.86 and a coverage of 0.33.鈥淏idirectional Economic Deficit鈥� characterized by the absence of both receiving and providing economic support. It has an average consistency of 0.85 and a coverage of 0.48.鈥淢ixed Type鈥� characterized by the free combination of intergenerational support across various dimensions. It has an average consistency of 0.83 and a coverage of 0.23.

Practical insights

Firstly, when studying the relationship between intergenerational support and older adults depression, besides employing linear research methods such as regression analysis, it is essential to complement the research with non-linear qualitative research methods.Secondly, adopting a holistic perspective to examine the complex connection between intergenerational support and older adults鈥� depression is essential. Focusing on intergenerational support configuration effects on depression in older adults. Thirdly, it is crucial to recognize the intergenerational support obligations of adult children, diligently fulfill the responsibility of caring for the older adults, and strive for a dynamic balance between receiving and providing intergenerational support to enhance the psychological well-being of the older adults.

Limitations and future directions

Firstly, while the Qualitative Comparative Analysis (QCA) method can identify the effects of intergenerational support configuration effects on older adults鈥� depression, it still lacks the in-depth exploration of micro-level issues that could be achieved through in-depth case studies. Subsequent related research should consider incorporating methods such as participant observation and in-depth interviews to delve deeper into the complex relationship between intergenerational support and older adults鈥� depression. Secondly, this study only analyzed data from a single year and did not encompass longitudinal sample data. This might limit the explanatory power of the research findings in terms of temporal dynamics. Further research could utilize longitudinal survey data to conduct more in-depth investigations.

Data availability

The datasets generated or analysed during the study are available in the repository, .

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Acknowledgements

The authors would like to acknowledge all participants of the National School of Development workshop at Peking University, as well as those who contributed to the 2018 China Health and Retirement Longitudinal Study (CHARLS).

Funding

Research on the mechanism of local excellent traditional culture helping the construction of 鈥淲enzhou Health鈥�. (Subject number: 23WSKZD05-3)

Author information

Authors and Affiliations

  1. School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China

    Qin Bai,听Shichen Chen,听Jinghui Zhu听&听Guilin Liu

  2. School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China

    Duanduan Fu,听Fang Wang听&听Baizhi Gao

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  1. Qin Bai

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  2. Duanduan Fu

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  3. Shichen Chen

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  4. Fang Wang

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  5. Baizhi Gao

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  6. Jinghui Zhu

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  7. Guilin Liu

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Contributions

QB took responsibility for the integrity of the data and the accuracy of the data analysis. DF, SC, FW, BGand JZ contributed to the writing of the manuscript and statistical analysis. GL study supervision. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jinghui Zhu or Guilin Liu.

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Ethics approval and consent to participate

All the respondents signed informed consent at the time of participation, and this study was approved by the Institutional Review Board of Peking University (IRB00001052鈥�11014).

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Not applicable.

Competing interests

The authors declare no competing interests.

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Bai, Q., Fu, D., Chen, S. et al. Configurational effects of intergenerational support on older adults鈥� depression: an empirical study from CHARLS data. 成人头条 25, 392 (2025). https://doi.org/10.1186/s12889-025-21532-x

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  • DOI: https://doi.org/10.1186/s12889-025-21532-x

Keywords

成人头条

ISSN: 1471-2458

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