Resilience and Perceived Social Support as Predictors of Physical and Psychological Quality of Life: A Multicentric Study in Dementia Caregivers.

Abstract

Family caregivers of people with dementia (PwD) face substantial caregiving demands and sustained stress, which increase the risk of adverse health outcomes. This study examined whether resilience and perceived social support (PSS) are associated with health-related quality of life (QoL) in family caregivers of PwD. In addition, mediation effects of main predictors through burden were computed to test directional pathways. A total of 317 family caregivers (mean age = 60.5 ± 14.5 years, 66.9% women) underwent a comprehensive interview measuring sociodemographic factors, burden (Zarit Burden Interview), resilience (Connor-Davidson Resilience Scale), PSS (Duke-UNC Social Support Questionnaire), and QoL dimensions, physical and psychological, (World Health Organization Quality of Life-Brief). The adjusted regression models showed that resilience significantly predicted both physical and psychological QoL, whereas PSS only predicted the psychological domain. The mediation analyses revealed a partial mediation effect of resilience through burden on QoL domains, whereas PSS showed a complete mediation effect on both domains. Finally, a moderated mediation analysis indicated that the indirect effect of resilience on QoL (through burden) was conditional on PSS levels. Thus, more substantial benefits of resilience were observed among caregivers reporting low to moderate PSS. These findings demonstrate that resilience operates through dual pathways (direct and via burden reduction), whereas PSS primarily alleviates burden. Both resources should be considered complementary targets for tailored interventions to improve QoL for family caregivers of PwD.