To evaluate the correlation between intergenerational support and overall survival (OS) of older adults.

Using data from six waves (2010—2020) of the China Family Panel Studies, we selected older adults aged ≥60 years at baseline in 2010 who had at least one child. Cox proportional hazards regression models were employed to analyze the association between intergenerational support and OS. Proportional hazards assumption was tested using Schoenfeld residuals, and stratified Cox models were applied to correct for variables that violated this assumption. Multivariable logistic regression models were used to examine differences in baseline characteristics among older adults receiving different types of intergenerational support. All analyses were stratified by urban and rural residence, adjusting for baseline age, sex, marital status, education level, and instrumental activities of daily living (IADL). Intergenerational support included financial support and instrumental support.

A total of 5 913 older adults were included. Stratified multivariate Cox regression analysis showed no association between financial support and OS (stratified adjusted HR_{yes vs no}=1.04, 95%CI: 0.93-1.17). In contrast, receiving instrumental support was associated with worse OS (stratified adjusted HR_{yes vs no}=1.20, 95%CI: 1.07-1.34). Urban-rural stratified analyses yielded consistent results. Multivariable logistic regression showed that older adults who were advanced in age, without a spouse, had lower education, or without IADL were more likely to receive financial support and instrumental support from their children (all P<0.050), with similar urban-rural patterns.

Receiving instrumental support was associated with poorer OS among older adults, while no correlation was found for financial support. Policy implications include strengthening social security safety net and utilizing the initiation of care receipt as a community alert to trigger early health interventions, thereby mitigating health risks and promoting healthy aging.