Jahangir Selim, Patil Divya Sussana, Gangopadhyay Jagriti, Vogt Tobias C
Health Demography & Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
Centre for Evidence-Informed Decision-Making, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, India.
Syst Rev. 2025 Apr 11;14(1):86. doi: 10.1186/s13643-025-02833-z.
Traditionally, family members take care of older relatives in South Asian societies, and there is a strong reciprocal filial obligation through intergenerational family relations. The changing family structure, living arrangements, and out-migration have led to subsequent changes in reciprocal family support that influence the health and well-being of older adults. This scoping review aims to (1) map the evidence and prevailing motivations for family support including financial, instrumental, and emotional support that affect the health and well-being of older adults and (2) identify the research gaps in the academic scholarship available on motivation for family support to older adults given the changing demographic and societal dynamics in the South Asian societies.
We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines. Electronic databases PubMed, Embase, Scopus, and ProQuest were searched, and Google Scholar was used to identify grey literature. The screening of titles, abstracts, and full texts included 22 studies for analysis.
The included studies covered health indicators such as stress and/or depression, loneliness/isolation, loss of support/neglect, and level of satisfaction to illustrate well-being of older adults. The findings revealed that adult children recognised filial duties and responsibilities to provide care to older parents, whereas older parents provide cultural upbringing and care to grandchildren. Reciprocal care exchange, cultural expectations, and intergenerational transfers motivated adult children to be primary caregivers to their older parents. Intergenerational family care such as financial, instrumental, and emotional support is associated with a higher level of life satisfaction and lower level of depression and thus reported better health and well-being among older adults.
Although intergenerational support is still a significant factor in determining the well-being of older adults in South Asia, this study shows the complexity of intergenerational ambivalence, where caregiving responsibilities lead to both emotional stress and a sense of obligation. Additionally, out-migration of adult children and subsequent physical absence also increase psychological distress and loneliness of older adults. This emphasises the need for policies that address both the emotional and financial aspects of elder care. The Madrid International Plan of Action on Ageing (MIPAA) policies can be adopted to ensure friendly and supportive environments and emphasise the health and well-being of older adults in developing countries. MIPAA highlights the importance of policies that promote intergenerational solidarity, active ageing, and social protection for older individuals.
在南亚社会，传统上由家庭成员照顾年长亲属，通过代际家庭关系存在着强烈的相互孝道义务。家庭结构、居住安排的变化以及外出移民导致了相互家庭支持的后续变化，这影响了老年人的健康和福祉。本综述旨在：（1）梳理影响老年人健康和福祉的家庭支持（包括经济、工具性和情感支持）的证据及主要动机；（2）鉴于南亚社会不断变化的人口结构和社会动态，找出关于老年人家庭支持动机的现有学术研究中的差距。
我们遵循系统评价和Meta分析扩展的范围综述（PRISMA-ScR）指南。检索了电子数据库PubMed、Embase、Scopus和ProQuest，并使用谷歌学术搜索灰色文献。对标题、摘要和全文的筛选纳入了22项研究进行分析。
纳入的研究涵盖了压力和/或抑郁、孤独/孤立、支持缺失/忽视以及满意度等健康指标，以说明老年人的福祉。研究结果表明，成年子女认识到照顾年迈父母的孝道责任，而年迈父母则为孙辈提供文化养育和照顾。相互的照顾交换、文化期望和代际转移促使成年子女成为年迈父母的主要照顾者。代际家庭照顾，如经济、工具性和情感支持，与更高的生活满意度和更低的抑郁水平相关，因此老年人的健康和福祉状况更好。
尽管代际支持仍然是决定南亚老年人福祉的一个重要因素，但本研究表明了代际矛盾情绪的复杂性，即照顾责任既会导致情感压力，也会带来责任感。此外，成年子女的外出移民以及随后的实际缺席也增加了老年人的心理困扰和孤独感。这强调了制定兼顾老年护理情感和经济方面的政策的必要性。可以采用《马德里老龄问题国际行动计划》（MIPAA）的政策，以确保友好和支持性的环境，并强调发展中国家老年人的健康和福祉。MIPAA强调了促进代际团结、积极老龄化以及为老年人提供社会保护的政策的重要性。
