Association between family support and health-related quality of life in older adults: the mediating role of resilience and cognition

Aim This study aimed to explore the effect of family support on HRQoL and the mediating role of resilience and cognition among older adults. Methods This cross-sectional study was conducted in October 2022, and a convenience sampling method was employed. The Perceived Social Support from Family Scale, the 12-Item Short Form Health Survey version 2, the Brief Resilience Scale, and the Montreal Cognitive Assessment were used to survey 619 older adults in Anhui and Zhejiang provinces. Results The total effect of family support on the physical component summary (PCS) of HRQoL was not significant (B = -0.190, 95% CI [-0.596∼0.215], P = 0.357), and resilience and cognition play the suppression effects in the association between family support and PCS of HRQoL (B = 0.851, 95% CI [0.632∼1.111]). Family support was significantly positively associated with the mental component summary (MCS) of HRQoL (B=0.957, 95% CI [0.655∼1.259]). Mediation model results indicated a significant direct effect of family support on MCS (B=0.474, 95% CI [0.174∼0.774], P = 0.002), accounting for 49.53% of the total effect. Family support affected MCS through three important mediation pathways. Resilience accounted for 39.71% (B=0.380, 95% CI [0.251∼0.538]) of the total effect, cognition for 7.94% (B=0.076, 95% CI [0.017∼0.161]), and the series mediation of resilience and cognition for 2.82% (B=0.027, 95% CI [0.006∼0.057]). Conclusions Enhancing family support for older adults may improve their MCS of HRQoL, with resilience and cognition mediating. However, older adults' family support and PCS of HRQoL were not significantly associated, and resilience and cognition suppressed their association.