Mediating effect of family functioning on depressive symptoms and family resilience in dementia caregivers

Front Public Health. 2026 May 11;14:1784746. doi: 10.3389/fpubh.2026.1784746. eCollection 2026.

ABSTRACT

BACKGROUND: Caregivers of individuals with dementia often assume substantial responsibilities and are vulnerable to mental health conditions such as depression, which may undermine both family resilience and overall family functioning.

OBJECTIVE: This study aimed to examine the association between depressive symptoms and family resilience among dementia caregivers, and to explore the potential mediating role of family functioning.

METHODS: A cross-sectional survey was conducted among 514 community-based caregivers of individuals with dementia. Participants completed the Self-Rating Depression Scale (SDS), the Family Resilience Assessment Scale (FRAS), and the General Functioning subscale of the Family Assessment Device (FAD-GF). Partial correlation analyses were used to assess the associations among key variables, and the bootstrap method was employed to evaluate the mediating effect of family functioning.

RESULTS: The mean family resilience score among caregivers was 99.78 ± 16.09. Family resilience was negatively correlated with depressive symptoms (r = -0.399, p < 0.001) and family functioning scores (r = -0.617, p < 0.001), while family functioning scores were positively correlated with depressive symptoms (r = 0.330, p < 0.001). Mediation analysis indicated that family functioning partially mediated the association between depression and family resilience, accounting for 44.39% of the total effect.

CONCLUSION: Family functioning mediates the impact of depression on family resilience. Interventions aimed at improving family functioning may help strengthen family resilience in caregivers of individuals with dementia.

PMID:42200121 | PMC:PMC13199328 | DOI:10.3389/fpubh.2026.1784746