Abstract
BACKGROUND: This study investigated the association between chronic diseases and depressive symptoms among older adults while also examining the mediating role of life satisfaction and the moderating role of multidimensional intergenerational relationships in this association. METHODS: Data were gathered from 3917 community-dwelling older adults in China. Chronic diseases were measured by summing the total number of diagnosed conditions self-reported from a checklist of 16 chronic illnesses included in the questionnaire. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale. Life satisfaction was measured by the Chinese version of the Satisfaction with Life Scale. Intergenerational relationships were assessed by the Intergenerational Relationship Quality Scale for Aging Chinese Parents, which includes four dimensions: consensual-normative solidarity, structural-associational solidarity, affectual closeness, and intergenerational conflict. We employed the PROCESS macro to test the hypothesized pathways. Specifically, Model 4 was used to examine the mediating effect of life satisfaction on the association between chronic diseases and depressive symptoms. Model 8 was then conducted to simultaneously assess the mediating role of life satisfaction and the moderating effects of different dimensions of intergenerational relationships. RESULTS: More chronic diseases were associated with more depressive symptoms. Life satisfaction mediated the association between chronic diseases and depressive symptoms. Among the four dimensions of intergenerational relationships, structural-associational solidarity was found to moderate both the direct pathway between chronic diseases and depressive symptoms and the indirect pathway through life satisfaction. CONCLUSIONS: These findings enhance our understanding of the association between chronic diseases and depressive symptoms and provide important insights that can guide policy-makers and practitioners in addressing the psychological challenges faced by older adults with chronic diseases.