# The association between death anxiety and nutrition awareness in elderly hospitalized patients: a dual-perspective analysis from person-centered and variable-centered approaches based on future time perspective

## TL;DR

This study explores how death anxiety in elderly hospitalized patients relates to nutrition awareness, finding that a future-oriented mindset can turn anxiety into motivation for healthier behaviors.

## Contribution

The study introduces a dual-perspective analysis combining person-centered and variable-centered approaches to examine death anxiety, future time perspective, and nutrition awareness.

## Key findings

- Death anxiety is positively associated with future time perspective and nutrition awareness.
- Future time perspective partially mediates the relationship between death anxiety and nutrition awareness.
- Three distinct subgroups of patients were identified based on death anxiety and future time perspective levels.

## Abstract

With the acceleration of global population aging, psychological health issues among elderly hospitalized patients have become increasingly prominent. Death anxiety, as a key psychological experience of existential threat, is associated with psychological adaptation challenges in older adults and may be related to health behavior intentions. Nutrition awareness is a critical factor in promoting rehabilitation and healthy aging; however, the associations between death anxiety and nutrition awareness, as well as potential psychological pathways, remain understudied.

This study aims to examine the associations among death anxiety, future time perspective, and nutrition awareness, while identifying group heterogeneity through latent profile analysis.

This study employed a cross-sectional design, recruiting elderly hospitalized patients (N = 557) from three tertiary Grade-A hospitals in Hangzhou and Chongqing, China. Measurements were conducted using the Death Anxiety Scale, Future Time Perspective Scale, and Nutrition Awareness Scale. Data analyses included descriptive statistics, correlation analysis, structural equation modeling, and latent profile analysis.

Death anxiety was significantly and positively associated with both future time perspective and nutrition awareness. Future time perspective demonstrated a significant indirect effect in the relationship between death anxiety and nutrition awareness, suggesting a partial mediation pattern. Latent profile analysis identified three distinct subgroups: “low death anxiety–low future time perspective,” “moderate death anxiety–moderate future time perspective,” and “high death anxiety–high future time perspective,” with the latter group demonstrating the highest levels of nutrition awareness.

Under the moderating influence of future time perspective, death anxiety can be transformed into a positive psychological driver for health-promoting behaviors. Enhancing future orientation and sense of life meaning in elderly patients can convert anxious emotions into motivation for health management, providing a scientific basis for individualized psychological-nutritional interventions.