Background: While living alone predicts depression in diverse ageing populations, the impact of multi-generational living is unclear. This study compared mid-late life depressive symptoms by living arrangements between societies with distinct kinship ties.

Methods: Repeated data on depressive symptoms and living arrangements over 4 years from 16,229 Chinese (age >= 45) and 10,403 English adults (age >= 50) were analyzed using multilevel mixed-effects logistic regression. Elevated depressive symptoms were identified using the Center for Epidemiological Depression Scale criteria in each study.

Results: Higher odds ratios (ORs) of elevated depressive symptoms were found in both Chinese and English adults aged<60 living with no partner but with children/grandchildren, compared to those living with a partner only. These ORs were greater for men (Chinese men: 3.09, 95% confidence interval: 2.00-4.78; English men: 3.44, 1.36-8.72) than for women (Chinese women: 1.77, 1.23-2.56; English women: 2.88, 1.41-3.67), after controlling for socioeconomic position, health behaviors, and health status. This male disadvantage was also observed for English, but not for Chinese, adults aged<60 living alone. For adults aged 60+, the increased odds among those living with no partner but with children/grandchildren and those living alone were smaller in both countries.

Limitations: Bias may exist because depressed participants are more likely to experience divorce or separation prior to baseline.

Conclusions: The relationship between living arrangements and depressive symptoms appears robust and consistent across social contexts, although the mechanisms differ. The protective role of partners in both China and England supports targeting those who do not live with partners to reduce depression.