The relationship between alexithymia, meaning in life, and quality of life in older breast cancer patients: a cross-sectional study based on variable-centered and person-centered perspectives.

BACKGROUND: Alexithymia, characterized by difficulties in identifying and expressing emotions, has been linked to diminished quality of life in older breast cancer patients, a vulnerable population facing multifaceted psychosocial challenges. While prior research has explored these associations, investigations have predominantly adopted a variable-centered approach, overlooking the potential statistical mediating role of meaning in life. Moreover, no studies have examined the heterogeneity of alexithymia and meaning in life through a person-centered lens, which may reveal distinct subgroups with different quality of life outcomes among older breast cancer patients. METHODS: A cross-sectional design was employed, recruiting 577 older breast cancer patients from four tertiary grade A hospitals in Sichuan Province, China, between April 2 and May 29, 2025. Participants completed validated self-report measures, including the 20-item Toronto Alexithymia Scale (TAS-20-C), the Meaning in Life Questionnaire (MLQ), the Quality of Life Scale (QOLS), and a demographic questionnaire. PROCESS macro (Model 4) was used to test a cross-sectional statistical mediation model from the variable-centered perspective, while latent profile analysis identified subgroups from the person-centered perspective. RESULTS: Variable-centered analyses showed that alexithymia was negatively associated with quality of life, and meaning in life statistically accounted for part of this association. Person-centered analyses identified two distinct latent profiles: a high alexithymia-low meaning in life subgroup, characterized by elevated emotional processing deficits and reduced purpose, and a medium alexithymia-medium meaning in life subgroup, exhibiting adaptive emotional regulation and strong existential coherence. The former subgroup reported significantly lower quality of life scores compared to the latter. CONCLUSION: By applying meaning construction theory through a dual-perspective framework, this study clarifies patterns of association among alexithymia, meaning in life, and quality of life in older breast cancer patients and highlights the value of person-centered profiling for targeted interventions. These findings offer novel theoretical insights and practical implications, such as tailored psychotherapeutic strategies that may enhance meaning-making and address alexithymia, with the potential to promote quality of life in this population.