Exploring the moderated mediation of stress and media use: Social support's impact on anxiety among older adults during the COVID-19 pandemic - Insights from a large-scale cross-sectional study in China.

Background: This study aimed to assess the prevalence of anxiety symptoms among the older adults, explore whether stress mediated the association between social support and anxiety symptoms, and investigate whether media use moderated the direct or indirect effects within the mediation model.

Methods: Questionnaires and scales were employed to collect data from 1143 individuals aged 60 years and older across 120 cities in China during the COVID-19 pandemic. The collected information encompassed sociodemographic characteristics, social support, anxiety, stress, and media use. Bivariate correlations were then used to analyze the relationships among the study variables. Finally, the mediation and moderated mediation models were examined using the PROCESS macro for SPSS.

Results: During the COVID-19 pandemic, 40.1 % of Chinese elderly experienced anxiety. Social support exhibited a negative correlation with anxiety. And, media use positively influenced both stress and anxiety. Stress partially mediated the relationship between social support and anxiety, with a mediation effect of 50.95 %. Notably, media use moderated the association between social support and anxiety, serving as both an indirect mediator (path a: Social support - Stress: B = 0.071, 95 % CI: 0.022, 0.120) and a direct mediator (path c': Social support - Anxiety: B = -0.066, 95 % CI: -0.111, -0.022).

Limitations: This study used a cross-sectional design, which restricts the ability to infer causal relationships.

Conclusion: Social support is proven to be a potent alleviator of anxiety among the elderly. Stress partially mediated this relationship, while the indirect and direct impact of this mediation was influenced by media use.

Brief Summary: This study underscores the heightened anxiety prevalence among Chinese elderly during the COVID-19 pandemic, emphasizing the critical role of social support in mitigating these effects. It discovers that while stress acts as a mediator, media use serves as a significant moderator in this dynamic. These findings advocate for the necessity of bolstering social support networks and encouraging prudent media use to effectively manage anxiety and stress among the elderly, particularly in challenging times like a pandemic.