Fluidity in filial piety: twenty-year associations of living arrangements on depression and life satisfaction and across chronic diseases among older adults in rural China

OBJECTIVES: Based on defamilization, individualization, and contingent intergenerational solidarity theories, this study developed a cultural defamilization framework. Longitudinal data were used to explore changes in the associations between living arrangements and psychological well-being amidst filial piety transformation in modernization. BACKGROUND: Over the past two decades, China has undergone rapid demographic, socioeconomic, and institutional transformations. Thus, older adults’ attitudes and needs regarding living arrangements may have changed, with varying impacts across historical time and the number of chronic diseases. METHODS: Eight waves of longitudinal data (2001–2021) collected in Anhui, China, were employed, including. 9,765 (person-wave) observations. Mixed linear models were used to examine the relationship between living arrangements and life satisfaction and depression, with a focus on interaction terms for time and chronic diseases to test for moderating roles. RESULTS: Compared to living with children, a negative correlation with life satisfaction and a positive correlation with depression for those living alone or with a spouse only decreased over time. A negative association between living in skipped-generation households and life satisfaction also diminished. As chronic diseases increased, life satisfaction declined more for older adults living alone, with a spouse only, or in a skipped-generation household, whereas no statistically significant association is observed for depression. CONCLUSION: Older adults may increasingly accept living apart from their children, but co-residing remains associated with better life satisfaction in the face of declining health and multimorbidity, revealing a shift in filial piety from an obedient form to one grounded in mutual needs. The findings highlight the resilience of older adults in adapting to these changes, suggesting that family policies in developing regions should consider both potential evolving needs and broader societal transformations.