The Impact of Social Support and Pain Catastrophizing on Quality of Life in Older Adults: The Mediating Role of Cognitive Flexibility

Abstract

This study aimed to examine how social support and pain catastrophizing predict the quality of life (QoL) of older adults, considering the mediating role of cognitive flexibility. A descriptive correlational design was applied with 385 older adults recruited through convenience sampling in Tehran. Participants completed the WHOQOL-BREF for QoL, the Pain Catastrophizing Scale (PCS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Cognitive Flexibility Inventory (CFI). Data were analyzed using Pearson’s correlation in SPSS-27 and structural equation modeling (SEM) in AMOS-21 to test direct and indirect relationships and model fit. Social support positively predicted QoL (β = 0.28, p = .001), while pain catastrophizing showed a negative effect (β = −0.33, p = .001). Social support (β = 0.47, p = .001) and pain catastrophizing (β = −0.39, p = .001) significantly predicted cognitive flexibility, which in turn positively predicted QoL (β = 0.44, p = .001). Indirect effects were significant, and the structural model showed good fit (CFI = .95, RMSEA = .055). Social support and pain catastrophizing influence older adults’ QoL directly and indirectly through cognitive flexibility. Interventions enhancing social support and strengthening cognitive flexibility skills may effectively improve well-being and life satisfaction in aging populations.