Hope as a mediator in the relationship between social support and death anxiety in older adults

Abstract Death anxiety is a prevalent concern in older adulthood that can significantly impair quality of life. Perceived social support has been recognized as a protective factor; however, the mediating mechanisms underlying its relationship with death anxiety remain underexplored. This study aimed to investigate the mediating role of hope in the association between perceived social support and death anxiety among older adults. In this cross-sectional study, 200 participants aged 60 years and older (mean age = 69.79 ± 7.19 years) were selected using stratified proportional random sampling and were recruited between May and July 2025. Death anxiety, hope, and perceived social support were measured using standardized questionnaires. Analyses involved descriptive statistics, multiple linear regression, and structural equation modeling (SEM) using SPSS 24 and AMOS 24 ( p < 0.05). Structural equation modeling indicated that perceived social support significantly and positively predicted hope (standardized coefficient β = 0.72, p = 0.001), and hope in turn significantly and negatively predicted death anxiety (standardized coefficient β = − 0.62, p = 0.001). The direct path from perceived social support to death anxiety was not statistically significant (β = 0.021, p = 0.886). The bootstrapped indirect effect of perceived social support on death anxiety through hope was significant (standardized coefficient β = − 0.45, 95% CI [− 0.70, − 0.21], p = 0.001), consistent with full mediation. The findings suggest that hope may serve as a psychological mechanism underlying the association between perceived social support and death anxiety in older adults. Hope-enhancing interventions, alongside strengthening social support networks, may represent a promising approach to addressing death anxiety, warranting evaluation in future longitudinal or intervention studies.