Title: Intergenerational family support and older adult frailty: findings from four prospective cohort studies
ABSTRACT: Objectives: This study aimed to examine the association between types of intergenerational family interactions and frailty index (FI) among older adults across countries with different cultural backgrounds, and to explore variations in these associations among older individuals. Methods: We conducted a comprehensive longitudinal, cross-cultural analysis, involving adults aged 60 years and older from four countries, each participating in a nationally representative longitudinal cohort study: the China Health and Retirement Longitudinal Study (CHARLS; Wave 1-Wave 4), the Korean Longitudinal Study of Aging (KLoSA; Wave 4-Wave 7), the Health and Retirement Study (HRS; Wave 11-Wave 14), and the English Longitudinal Study of Ageing (ELSA; Wave 7-Wave 9). Results: Associations varied across countries. In the U.S., greater time spent on grandchild care was significantly associated with a lower FI, whereas more frequent intergenerational contact was marginally associated with a lower FI only in China. Downward economic support was associated with a higher FI in China (amount) and in the U.S. and the U.K. (any transfer), while upward economic support was marginally associated with a higher FI in Korea (amount) and significantly associated with a higher FI in the U.S. (any transfer) but was not statistically significant in China. Discussion: These findings suggest that certain forms of intergenerational family interactions may be associated with lower frailty among older adults, warranting further investigation.
Keywords: Intergenerational family interactions Older adults Frailty Cross-national comparison
DOI: https://doi.org/10.1016/j.ssmph.2026.101934
