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Background  It is not well clear how psychosocial factors like depressive symptoms, social support affect quality of life in rural elderly in China. This study aimed to investigate the mediating role of depressive symptoms in the association between social support and quality of life.    Methods  Cross-sectional data of 420 rural elderly were taken from four villages in Hangzhou City. They were interviewed with a demographic questionnaire, the Patient Health Questionnaire (PHQ-9) for depression, the Medical Outcomes Study Social Support Survey (MOS-SSS) for social support, and the short version of World Health Organization Quality of Life Assessment (WHOQOL-BREF) for quality of life. Mediation was examined by a nonparametric Bootstrapping method, controlling for socioeconomic variables.    Results  Poor quality of life was associated with low social support and increased depressive symptoms. A significant indirect effect of social support existed through depression in relation to quality of life (ab = 0.0213, 95% CI [0.0071, 0.0421]), accounting for 9.5% of the effect of social support on quality of life. Approximately 4.8% of the variance in QOL was attributable to the indirect effect of social support through depressive symptoms.    Conclusions  Depressive symptoms mediated the impact of social support on quality of life among rural older adults.

Mediating effects of depressive symptoms on social support and quality of life among rural older Chinese