Filial discrepancy and mortality among community-dwelling older adults: a prospective cohort study

Objectives: Adult children play a significant role in ageing parents' health and well-being. However, the evidence is mixed regarding whether the parent-child relations will affect older adults' longevity. This study aims to investigate the relationship between filial discrepancy and mortality risk. Method: Data were derived from a prospective cohort study from 2011 to 2017 of US Chinese older adults aged 60 and above in the Greater Chicago area, with a median of follow-up of 5.28 years. Filial discrepancy was assessed by the gap between filial expectation and receipt, including six domains (discrepancy in respect, greet, care, obey, make happy, and financial support). Mortality ascertained during follow-up. Cox proportional hazards models were used. Results: Among 3,021 participants, care expectation was least fulfilled while financial expectation was better fulfilled compared with other filial discrepancy domains. Compared with no respect discrepancy, older adults with respect expectation above receipt had higher risk of mortality (HR, 1.44; 95%CI, 1.07-1.94). Older adults with higher greet expectation than receipt experienced greater risk of mortality (HR, 1.56; 95%CI, 1.16-2.09) than those with no greet discrepancy. Older adults with care receipt above expectation had lower risk of mortality (HR, 0.75; 95%CI, 0.56-1.00). Conclusion: This study extends the relative standards model to investigate mortality outcomes. The findings add new insights to the association between parent-child relations and mortality risk. It is suggested that educational programs could focus on fostering young immigrants' attitude and behavior to provide more respect and greeting for aging parents to strengthen the family protection role.