Relationship between neuropsychiatric symptoms and social support in older adults with mild behavioral impairment: a moderated mediation model

Understanding the factors contributing to neuropsychiatric symptoms (NPS) in older adults with mild behavioral impairment (MBI) is crucial for developing effective interventions. Although psychological resilience and social support are key factors related to NPS, with anxiety and sleep quality playing significant roles, the precise mechanisms underlying their relationships remain unclear. Therefore, we conducted a cross-sectional survey of 328 older adults with MBI in 42 nursing homes across nine cities in Fujian Province, Southeast China, and investigated how psychological resilience, sleep quality, and anxiety influence the relationship between social support and NPS in older adults with MBI. Our findings showed that social support was significantly linked to NPS (β = -0.194, p < 0.001); psychological resilience mediated the relationship between social support and NPS (β = -0.219; confidence interval: -0.291, -0.153); sleep quality moderated the relationship between psychological resilience and social support (β = 0.141, p < 0.001); and anxiety moderated the relationship between social support and NPS (β = -0.117, p = 0.019), as well as that between psychological resilience and NPS (β = -0.189, p < 0.001). These findings highlight the potential of exploring resilience-focused interventions and their effects on social support and NPS in older adults with MBI.