The Mediating Role of Resilience in the Relationship Between Anticipatory Grief and Quality of Life in Caregivers of People with Dementia: A Cross-Sectional Study.

Background/Objectives: Caring for dementia patients involves a significant emotional burden for family caregivers, who confront anticipatory grief (AG) processes that can negatively affect their health-related quality of life (HRQoL). This study examines the mediating role of resilience in the relationship between AG and HRQoL. Methods: A cross-sectional study was conducted with 144 family caregivers of people with dementia in the province of Alicante (Spain). Validated instruments were applied to measure AG (Caregiver Grief Scale), HRQoL (SF-12), and resilience (Brief Resilient Coping Scale). Descriptive analyses, Pearson correlations, and hierarchical regressions were used, as well as a mediation model based on Hayes' PROCESS macro. Results: AG was negatively associated with resilience (r = -0.19, p = 0.025) and with both mental (r = -0.24, p = 0.004) and physical (r = -0.22, p = 0.009) components of HRQoL, whereas resilience was positively associated with mental HRQoL (r = 0.35, p < 0.001). In regression analyses, AG (B = -3.36, p = 0.006) and resilience (B = 1.16, p < 0.001) were significant predictors of mental HRQoL, explaining 30.4% of the variance (R2 = 0.30). Mediation analyses showed a significant indirect effect of AG on mental HRQoL through resilience (B = -1.28, 95% bootstrapped CI [-2.31, -0.84]), indicating partial mediation. Conclusions: Although AG negatively impacts HRQoL, resilience emerges as a relevant protective resource, especially for caregiver mental health. Therefore, it is crucial to promote resilient coping strategies in interventions that target this vulnerable population.