Age and resilience amid COVID-19 pandemic adversity: the mediating roles of quality of life, spirituality, and depressive symptoms

Leonardo Gonçalves^1,2,3LORENZO CASAGRANDE REGGIANI^1,2,3*Josiane Maliuk³Gianfranco Rizzotto de Souza³Renato Gorga Bandeira de Mello⁴BRUNO PEROSA CARNIEL^1,2,3NEUSA SICA DA ROCHA^1,2,3,5

• ¹Clinical Research Center, Clinical Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
• ²Graduate Program in Psychiatry and Behaviour Science, Federal University of Rio Grande do Sul, Porto Alegre, Rio de Janeiro, Brazil
• ³Innovations and Interventions in Quality of Life Research Group (I-QOL), Federal University of Rio Grande do Sul, Porto Alegre, Rio de Janeiro, Brazil
• ⁴Division of Internal Medicine, Clinical Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
• ⁵Division of Psychiatry, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil

Introduction: Resilience scores are usually higher among older adults, but the COVID-19 pandemic and the associated social isolation in this risk group necessitate a reevaluation of this characteristic. Objectives: To investigate the differences in resilience among young, middle-aged, and elderly individuals and to explore the mediating factors (quality of life, spirituality, social support, depressive symptoms) in the relationship between age and resilience. Methods: A cross-sectional study was conducted in April 2020 through online collection using the snowball method, enrolling 3,278 participants. They were divided into three age groups (18-36, 37-59, 60+), and resilience was assessed using the CD-RISC-10 scale. Mediation analyses examined the roles of depressive symptoms (PHQ-9), quality of life (EUROHIS-QOL-8), spirituality (WHOQOL-SRPB), and social support (MOS). Results: The sample comprised 1,207 young, 1,680 middle-aged, and 391 older adults. Resilience scores were significantly higher in the elderly population compared to middle-aged and young adults (F[2,3251]=81.12; p=0.001). Quality of life (β=0.23; p=0.001) and spirituality (β=0.28; p=0.001) showed positive mediating effects, while depressive symptoms (β= -0.18; p=0.001) had a negative effect. Social support did not show a statistically significant mediating effect. Conclusion: Older age was associated with higher resilience scores, even during COVID-19 pandemic. Spirituality and quality of life were identified as mediators of this relationship. These findings underscore the need for longitudinal research to confirm whether these factors predict resilience and to guide mental health interventions.