Association between Intergenerational Care based on Living arrangements and Cognitive Function in Middle-Aged and Older Adults—The mediation roles of Social activities and Depressive symptoms

Abstract Background: In the context of an ageing population and age-related conditions increasing, more and more middle-aged and older persons are involved in grandchildren care. This study aims to investigate the association between intergenerational care based on living arrangements and cognitive function, and explore the mediating effects of social activities and depressive symptoms on grandchildren care and cognition.Methods: This study selected 5490 Chinese people (≥45 years old) from 2018 China Health and Retirement Longitudinal Study (CHARLS). Participants answered questions related to socio-demographics, Mini-mental State Examination, grandchildren care, the intensity of grandchildren care, Center for Epidemiologic Studies Depression Scale and social activity. Results: This study found that caring for grandchildren and co-habited with spouse had a significant positive effect on cognitive function among the middle-aged and elderly people (B=0.829, p<0.001). Furthermore, providing intensive or no-intensive children care positively influenced cognitive function. In contrast, providing intergenerational care but not co-habited with spouse negatively affected cognition (B=-0.545, p<0.05). Moreover, caring for grandchildren had direct and indirect effects on cognition, as mediated by social activities and depressive symptoms. Conclusion: This study highlights that providing grandchildren care and co-habited with spouse is associated with better cognition. The social activities and depressive symptoms act as moderated roles between caring for grandchildren and cognition. The findings emphasize the living arrangement, social engagement and psychological health could be considered when encouraging grandparenting care as a complement to formal care.