Associations of Frailty and Caregiver Burden with Quality of Life among Family Caregivers of Community-dwelling Frail Older Adults: the Roles of Mastery, Competence and Social Support

BACKGROUND: Though frailty and caregiver burden are primary stressors that markedly shape caregivers' care-related quality of life (CarerQoL), the underlying pathways are yet to be elucidated. OBJECTIVE: To investigate the mediating role of mastery and competence in the association of 3 dimensions of frailty (ie, physical, psychological, and social frailty) and caregiver burden with CarerQoL, and the moderating role in this process among family caregivers of frail older adults. METHODS: This was a cross-sectional study involving 464 family caregivers of frail older adults living in communities in China. Path analysis was employed to test the moderated mediation model using AMOS 28.0. RESULTS: Social frailty and caregiver burden were directly associated with CarerQoL. Social support moderated the associations between physical frailty and mastery, between caregiver burden and competence, and between social frailty and CarerQoL. The mediating role of mastery in the association of physical frailty with CarerQoL was not significant, and the mediating role of competence in the association of caregiver burden with CarerQoL was persistent, though the latter was moderated by social support. CONCLUSION: The direct and indirect effects of care recipients' frailty on caregivers' CarerQoL, as well as the moderating role of social support, vary by frailty types. Social support buffers the detrimental impact of caregiver burden on CarerQoL via competence. The findings highlight the importance of social support in the caregiving process and its differential buffering role by primary and secondary stressors, guiding the development of tailored strategies to enhance the quality of life of caregivers.