Can Two-Way Intergenerational Support Better Protect Cognitive Function in Chinese Older Adults? A Nationally Representative Study

Background: Intergenerational support plays a vital role in maintaining cognitive health among older adults. However, whether two-way intergenerational support offers greater protection of cognitive function compared with one-way support—either provided or received—remains poorly understood. Methods: Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2011-2018). An Ordered Probit (Oprobit) model was used to estimate the effect of intergenerational support on cognitive function. Robustness was assessed using the Instrumental Variables with Conditional Mixed Process (IV-CMP) method, and heterogeneity was examined by stratifying the data by residence and gender. Results: Two-way financial, caregiving, and emotional support significantly reduced the risk of cognitive impairment in older adults, particularly in severe cases. Two-way financial support was more effective than either support provided or received alone in reducing the risk of cognitive impairment, whereas two-way caregiving was less effective than providing caregiving support alone. Among the three types of two-way intergenerational support, two-way caregiving demonstrated the strongest protective effect against cognitive impairment in older adults, whereas two-way financial support exhibited the weakest. Finally, notable rural–urban and gender disparities were observed to influence intergenerational support on the risk of cognitive impairment, underscoring the need for targeted interventions to address cognitive decline across diverse demographic groups. Conclusions: The study highlights the protective effects of two-way intergenerational support on cognitive function among older Chinese adults and reveals variations across support types and demographic groups. The findings offer invaluable insights for promoting cognitive health in older adults.