relationship of loneliness, perceived social support, and dysfunctional attitudes with death anxiety in older adults; the mediating role of spiritual health

Aims: death anxiety is a common concern in late adulthood, increasingly influenced by loneliness and perceived social support. this study explored the mediating role of spiritual health in the relationships between loneliness, perceived social support, and dysfunctional attitudes and their impact on death anxiety in older adults. instrument & methods: a cross-sectional survey design was employed with a sample of older adults aged 60 and above (n=384) from may to july 2024 in shahr-e-rey, iran. participants completed validated questionnaires assessing loneliness, perceived social support, dysfunctional attitudes, spiritual health, and death anxiety. structural equation modeling was utilized to analyze the data and assess the mediating effects of spiritual health.findings: there was a significant positive correlation between loneliness and death anxiety (p<0.05), indicating that higher loneliness levels were associated with increased death anxiety. additionally, perceived social support correlates negatively with loneliness, suggesting that greater social support reduces feelings of loneliness. spiritual health demonstrated a significant mediating effect (p<0.05) as it was positively influenced by perceived social support and negatively impacted by loneliness, ultimately leading to reduced death anxiety. dysfunctional attitudes also emerged as a significant predictor of death anxiety.conclusion: enhancing spiritual health through strengthening perceived social support is a viable strategy to alleviate death anxiety among older adults. addressing loneliness and fostering supportive social relationships can improve older adults’ mental health and quality of life.