Depression and resilience mediates the effect of family function on quality of life of the elderly.

BACKGROUND: Family function, which improves individual resilience and strongly link to quality of life (QOL) among the elderly, increases the risk of depression. Because of these demonstrated relationships, it can be hypothesized that both depression and resilience are mediators of the association between family function and QOL.

METHODS: To test this hypothesis, the structural equation model (SEM) constructed by Amos 21.0 was employed to assess the indirect effect of depression (Geriatric Depression Scale, GDS) and resilience (Connor-Davidson Resilience Scale, CD-RISC) on the relationship between family function (Family APGAR Score, APGAR) and QOL (12-item Short Form health survey, SF-12) in 474 elderly adults from three communities in Guangzhou, China.

RESULTS: Correlation matrix showed that depression is significantly negatively correlated with family functioning (r=-0.54, P<0.01), resilience (r=-0.46, P<0.01) and QOL (r=-0.63, P<0.01), while resilience is significantly positively correlated with family functioning (r=0.35, P<0.01) and QOL (r=0.40, P<0.01). SEM indicated that Family functioning appeared to have significant indirect effects through resilience (β=0.089) and depression (β=0.307; combined β=0.056) on QOL (R2 =0.55). The model fit indices showed a good fit of the model of the data (χ2 /df=1.362, P>0.05, SRMR=0.023, RMSEA=0.028, GFI=0.985, NFI=0.987, TLI=0.993, CFI=0.996).

CONCLUSIONS: The finding supports the assumption that depression and resilience are consistent intermediary factors of the relationship between family function and QOL among the elderly.