There are roughly 220 million adults in China aged 65 or older, more than twice as many as 20 years ago, with 1 in 5 currently reporting depressive symptoms.

“That rapid population aging makes understanding factors contributing to late-life mental health issues increasingly urgent,” says Chang Yu, the author of a new study conducted while she was a doctoral candidate in the UB Department of Sociology and Criminology, College of Arts and Sciences.

Using six years of data covering four time points between 2014 and 2020 from the China Longitudinal Aging Social Survey, Yu and her co-authors, Emily Zang, associate professor of sociology at Yale University, and Jiaowei Gong, a doctoral student in sociology and demography at the University of California, Berkley, examine how older adults’ relationships with their children shape their health over time. The sample consisted of 3,519 older parents in China with at least two working-age children.

The study, published in May in The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, identifies distinct trajectories that are related to depressive symptoms in older adults.

“The most strained parent-child relationship may be especially consequential for older parents’ mental health because severe conflict or emotional distance from one child, in a multi-child family, can cause persistent stress and threaten parents’ sense of competence and identity,” Yu says. “Even positive relationships with other children in the family may not fully offset these negative effects.”

But these effects are not fixed, and Yu underscores the importance of treating intergenerational relationships as dynamic.

“Prior research often explored whether a parent-child relationship is ‘good’ or ‘bad’ at one point in time, but it’s important to go beyond baseline quality and look at how relationships change over time,” she says.

The findings suggest that sustained improvements or declines in a relationship can be important predictors of depressive symptom risk.

“These shifts in trajectories have important mental health consequences, suggesting that the ‘worst tie’ deserves particular attention,” she says. “We also noticed inequality in the sense that older adults with a lower socioeconomic status may be more emotionally affected by changes in family relationships because they lack certain resources and may rely more heavily on family support.”

Yu says the study’s results can inform community aging services, family counseling, social work practice and mental heal screening for older adults.

“Programs that support older adults should not only ask whether they have children or receive support from children, but they should also ask whether there is a strained relationship within the family,” says Yu. “Family-based interventions could focus on improving communication and repairing the most strained parent-child relationship.”

But family repair is not simple, notes Yu.

“Effort is needed from both the parent and the child, but this research does show that improvements in strained relationships are linked to better mental health,” she says. “That makes relationship repair a potentially useful target for aging services and family support programs.”