Decoding apathy in the middle-aged and older adults: the indirect effect of loneliness and the moderating effect of cognitive function on resilience

Apathy, a multi-dimensional construct characterized by diminished motivation and emotional indifference, is a prevalent yet underexplored condition in middle-aged and older adults. This multifaceted condition significantly impacts daily activities and overall well-being. While resilience and cognitive abilities have been proposed as potential protective factors against apathy, their interplay with the condition remains poorly understood. This study aimed to investigate the indirect effect of resilience on multi-dimensional apathy via loneliness and to assess further whether this indirect effect is moderated by cognitive function. A cohort of 218 community-dwelling adults aged 50 years and older was recruited. Participants provided demographic information and completed validated questionnaires to assess resilience, loneliness, and multi-dimensional apathy, along with performance-based cognitive tests. The moderated mediation model was analyzed using the PROCESS macro in SPSS. Our findings revealed that loneliness accounted for a statistically significant indirect effect in the association between resilience and multi-dimensional apathy, specifically for the domains of cognitive and social motivation (B = −0.046, 95% CI [−0.08, −0.02]) and spontaneous behavioral activation (B = −0.024, 95% CI [−0.04, −0.01]). Notably, cognitive function moderated the indirect association between resilience and multi-dimensional apathy via loneliness (B = −0.070, p < 0.001, 95% CI [−0.11, −0.03]), indicating that the indirect influence of resilience on multi-faceted apathy diminished with declining cognitive function. By uncovering the intricate relationships between resilience, loneliness, multi-dimensional apathy, and cognitive function, our study offers groundbreaking insights into combating apathy in the aging population. The emphasis on enhancing resilience and cognitive capabilities presents a forward-thinking approach to mitigating the adverse effects of loneliness, heralding a new direction in fostering a resilient and cognitively engaged elderly community.