Unlocking the relationship between care preference-reality consistency and depressive symptoms among Chinese older adults: the roles of social adaptation and satisfaction with care.

OBJECTIVES: This study examined the association between care preference-reality consistency and depressive symptoms among older adults, focusing on social adaptation as a moderator and satisfaction with care as a mediator. METHOD: Using data from the China Longitudinal Aging Social Survey, we analyzed 2,830 older adults with care needs (age: M = 77.35, SD = 8.20). Ordinary least squares regression models, propensity score weighting, simple slope analyses, and relative mediation analysis were conducted to test the hypotheses. RESULTS: Compared with care preference-reality match, both joint-care preference partial mismatch (hereafter, partial mismatch) and mismatch were associated with higher depressive symptom scores. These associations were weaker among older adults with higher levels of social adaptation. A statistically significant indirect association through satisfaction with care was observed for mismatch, but not for partial mismatch. CONCLUSION: This study provides preliminary cross-sectional evidence that care preference-reality consistency is associated with depressive symptoms among older adults in China. The findings underscore the protective role of social adaptation and mediating mechanism of satisfaction with care. Policymakers and practitioners could use this knowledge to design interventions that focus on care preference, social adaptation, and satisfaction with care to support older adults' mental health.