Parental loss of a child and psychosocial outcomes among middle-aged and older adults: Longitudinal national evidence from Thailand, 2015–2022

Abstract

Objectives: The aim of this study was to assess the longitudinal assocation between the onset of parental loss of a child and psychosocial health outcomes among middle-aged and older adults in Thailand from 2015 to 2022. Methods: We used information from four waves of the Health, Aging, and Retirement in Thailand study. Overall, 1558 observations of parental loss of a child and 12,376 observations of parents without child death from four research assessments in 2015, 2017, 2020, and 2022 made up the pooled analytic sample. Among the total analytic sample, the average age was 68.7 years (SD = 11.9 years, ranging from 45 to 107 years). Established measures were used to assess child death, and psychosocial health status. Linear fixed-effects (FE) regressions were utilized to estimate the longitudinal assocation between the transition to parental loss of a child or children and depressive symptoms and subjective life expectancy. Results: Linear FE regressions adjusted for potential confounders showed a positive association between the transition to child death, number of child loss and depressive symptoms in the entire sample, in both sexes, and in middle-aged and/or older adults. In age group stratified analysis, a negative association between the transition to child death, number of child loss and subjective life expectancy was found in the middle-aged group. Conclusions: Parental loss of children were associated (with small effect sizes) with depressive symptoms among middle-aged and older adults and reduced subjective life expectancy among middle-aged adults in Thailand, showing its unique contributions (e.g., nationally representative longitudinal data from Thailand, filling an evidence gap in Southeast Asia). Policy and practice implications may include screening bereaved parents for depression, strengthening community or religious support, or developing tailored interventions.