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This study examines caregiving patterns based on participation levels in parent care, spouse care, and grandchild care, and tests whether these patterns predict later depressive symptoms. Data come from 2011–2018 China Health and Retirement Longitudinal Study waves, using 11,775 participants aged 50+ in 2011. Latent class analysis identifies four patterns, and regression links baseline patterns to seven-year follow-up depressive symptoms.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/patterns-of-multiple-caregiving-and-the-influence-on-depressive-symptoms-among-middle-aged-and-older-adults-in-china/450380/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/patterns-of-multiple-caregiving-and-the-influence-on-depressive-symptoms-among-middle-aged-and-older-adults-in-china/450380.png","ImageObject",300,407,{"name":92,"@type":93},"\tJames","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What caregiving roles are used to define the multiple caregiving patterns?","Question",{"text":112,"@type":113},"Patterns are based on participation levels in parent care, spouse care, and grandchild care.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How are the caregiving patterns identified and tested for mental health outcomes?",{"text":117,"@type":113},"Latent class analysis identifies four patterns from the 2011 cohort, and a regression model assesses associations between baseline patterns and subsequent depressive symptoms.",{"name":119,"@type":110,"acceptedAnswer":120},"Which caregiving patterns are linked to higher depressive symptoms after seven years?",{"text":121,"@type":113},"Compared with “part-time care for all,” both “full-time spouse care” and “part-time spouse care” report significantly greater depressive symptoms seven years later.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},450380,1790762925,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","European Journal of Ageing (2026) 23:5  \n[https://doi.org/10.1007/s10433-025-00904-7](https://doi.org/10.1007/s10433-025-00904-7)  \nPatterns of multiple caregiving and the influence on depressive symptoms among middle‑aged and older adults in China  \nXinyi Zhao1 · Quan Zhang2 · Vivian W. Q. Lou3 · Siqing Tao1  \nReceived: 20 August 2024 / Accepted: 4 December 2025 © The Author(s) 2025  \nAbstract  \nWith extended life expectancy, middle-aged and older adults have become more involved in multiple types of caregiving. This study aimed to investigate the patterns of multiple caregiving on the basis of the level of participation in parent care, spouse care, and grandchild care and to determine whether these patterns predict follow-up depressive symptoms. Data were obtained from the 2011–2018 waves of the China Health and Retirement Longitudinal Study. A total of 11,775 participants aged 50 years and older in 2011 were included in the latent class analysis to identify the patterns of multiple caregiving. A regression model was used to analyse the associations between baseline caregiving patterns and subsequent depressive symptoms. The results revealed four caregiving patterns: “part-time care for all,” “full-time parent care and grandchild care,” “part-time spouse care,” and “full-time spouse care.” Compared with the “part-time care for all” group, the “full-time spouse care” group and the “part-time spouse care” group reported significantly greater depressive symptoms seven years later, whereas the “full-time parent care and grandchild care” group did not significantly differ. The use of categorising multiple caregiving could vividly describe middle-aged and older adults’ engagement in caregiving activities and provide a comprehensive prediction of mental health outcomes. Social services should be tailored to sandwiched caregivers in certain caregiving patterns.  \nKeywords Multiple caregiving · Caregiving patterns · Depressive symptoms · Middle-aged and older adults · Sandwich generation  \nIntroduction  \nMiddle-aged and older adults play a crucial role in family caregiving. They often assume caregiving responsibilities when their older parents or spouses experience illness or functional impairments (Gruijters 2017 ; Zhao et al. 2023) . Moreover, middle-aged and older adults are highly involved in grandparenting. For example, more than half of the grandparents in China provide childcare (Zhang et al. 2020), which is reinforced by the relatively young retirement age (i.e. 50 or 55 for females and 60 for males) in  \n* Vivian W. Q. Lou wlou@hku.hk  \n1 School of Health Humanities, Peking University, Beijing, China  \n2 Department of Economics, University of California Los Angeles, Los Angeles, CA, USA  \n3 Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China  \nthis country (Falkingham et al. 2020) . Owing to extended life expectancy, increased labour participation in females, and delayed marriage and childbearing, the period in which middle-aged and older adults need to care for their parents, spouses, and/or grandchildren may overlap, increasing the likelihood that they will take on multiple caregiving roles. From 1990 to 2020, the average life expectancy in China increased from 68.55 years to 77.93 years, whereas the average age of women giving births for the first time increased from 24.03 years to 29.13 years (Office of the Leading Group of the State Council for the Seventh National Population Census 2022) . Although there have been studies on the effects of family caregiving on mental health among middle-aged and older adults, research specifically addressing multiple caregiving roles is still lacking. Therefore, it is imperative to investigate the patterns of multiple caregiving activities and their impact on mental health.  \nFamily caregiving and mental health among middle‑aged and older adults  \nPrevious studies on the impact of family caregiving on mental health have focused p","cbCaiivLrltLKCRQ","https://ap.wps.com/l/cbCaiivLrltLKCRQ","pdf",605260,17,"English","# Abstract\n# Introduction\n## Family caregiving and mental health among middle-aged and older adults\n## Dual caregiving of the sandwich generation","[{\"question\":\"What caregiving roles are used to define the multiple caregiving patterns?\",\"answer\":\"Patterns are based on participation levels in parent care, spouse care, and grandchild care.\"},{\"question\":\"How are the caregiving patterns identified and tested for mental health outcomes?\",\"answer\":\"Latent class analysis identifies four patterns from the 2011 cohort, and a regression model assesses associations between baseline patterns and subsequent depressive symptoms.\"},{\"question\":\"Which caregiving patterns are linked to higher depressive symptoms after seven years?\",\"answer\":\"Compared with “part-time care for all,” both “full-time spouse care” and “part-time spouse care” report significantly greater depressive symptoms seven years later.\"}]","Patterns of multiple caregiving and the influence on depressive symptoms among middle-aged and older adults in China | PDF",1790733022,43]