Health Anxiety and Quality of Life in Older Adults With Chronic Illness: The Mediating Roles of Emotion Regulation and Perceived Social Support

Elahe Heydari

Authors

Elahe Heydari Ph.D. in Educational Psychology, Department of Educational Sciences, Farhangian University, Zahedan, Iran Corresponding Author https://orcid.org/0000-0002-4966-812X

Keywords:

Health Anxiety, Quality of Life, Older Adults, Chronic Illness, Emotion Regulation, Perceived Social Support, Structural Equation Modeling

Abstract

This study aimed to investigate the relationship between health anxiety and quality of life in older adults with chronic illness and to examine the mediating roles of emotion regulation and perceived social support in this relationship.

Methods and Materials: This cross-sectional descriptive-correlational study was conducted among 360 older adults aged 60 years and above with at least one physician-diagnosed chronic illness who were recruited from selected healthcare and community-based centers in Tehran, Iran, during 2026. Participants completed the Short Health Anxiety Inventory, World Health Organization Quality of Life-OLD instrument, Emotion Regulation Questionnaire, and Multidimensional Scale of Perceived Social Support. Data were analyzed using Pearson correlation coefficients, confirmatory factor analysis, and structural equation modeling in SPSS and AMOS. Model fit was evaluated using χ²/df, CFI, TLI, RMSEA, and SRMR. Indirect effects were tested using a nonparametric bootstrap procedure with 5,000 resamples and bias-corrected 95% confidence intervals.

Findings: Health anxiety was negatively associated with quality of life (r = -.58, p < .001), adaptive emotion regulation (r = -.46, p < .001), and perceived social support (r = -.39, p < .001). In the structural model, health anxiety negatively predicted quality of life (β = -.29, p < .001), emotion regulation (β = -.47, p < .001), and perceived social support (β = -.40, p < .001). Emotion regulation (β = .37, p < .001) and perceived social support (β = .33, p < .001) positively predicted quality of life. The indirect effects through emotion regulation (β = -.17, 95% CI [-.24, -.12]) and perceived social support (β = -.13, 95% CI [-.19, -.08]) were significant. The model explained 58% of the variance in quality of life.

Conclusion: Health anxiety is associated with poorer quality of life among older adults with chronic illness both directly and indirectly through reduced adaptive emotion regulation and lower perceived social support, highlighting the importance of integrated psychological and social interventions in chronic disease care.

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