Introduction:The C-reactive protein-albumin-lymphocyte (CALLY) index represents a novel composite biomarker integrating inflammatory, nutritional, and immune parameters. We aimed to examine the relationship between CALLY index and chronic kidney disease (CKD) prevalence. Material and methods:This cross-sectional analysis utilized data from the National Health and Nutrition Examination Survey. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g. Multivariable logistic regression and restricted cubic spline (RCS) analyses assessed the relationship between CALLY index and CKD risk. Among CKD patients, Cox proportional hazards models evaluated associations of the CALLY index with all-cause and cardiovascular mortality. Results:Among the 26 996 participants, 4997 individuals were diagnosed with CKD. Participants with CKD demonstrated lower CALLY index values compared to those without CKD. Multivariable logistic regression indicated that, compared to the lowest quartile, the highest quartile showed 29.5% reduced CKD risk (OR = 0.705, 95% CI: 0.589-0.845, p < 0.001). The RCS model demonstrated a significant L-shaped association between CALLY index and CKD prevalence. Among CKD patients, higher CALLY index significantly predicted better survival outcomes for both all-cause and cardiovascular mortality. Conclusions:The CALLY index demonstrates inverse associations with CKD risk and mortality, suggesting its potential utility as a comprehensive biomarker for CKD risk stratification and prognosis assessment.

This study aims to synthesize the perceptions and expectations of long-term caregivers regarding the use of nursing robots to inform strategies for enhancing the quality and operational efficiency of care services. Global poulation aging has exacerbated long-term caregiver burnout and critical staff shortages. Nursing robots present a potential solution to mitigate these challenges and improve care standards. We conducted a meta-synthesis of qualitative studies, searching eleven databases (PubMed, Web of Science, Embase, CINAHL, Scopus, Cochrane Library, PsycINFO, SinoMed, China National Knowledge Infrastructure, Wanfang, and Vip) from their inception through January 1, 2025, for publications in Chinese and English. The search strategy utilized a comprehensive set of terms related to four core concepts: long-term caregivers, nursing robots, long-term care settings, and perceptions/experiences. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tools. Following a rigorous screening and data extraction process, a thematic synthesis of 26 included studies was conducted using NVivo software. The analysis yielded three analytical themes and nine sub-themes: (1) Affirmation and Acceptance, (2) Concerns and Challenges, and (3) Expectations and Requirements. Findings reveal that while most long-term caregivers are enthusiastic about nursing robots, they also express significant concerns about technical reliability, safety, and privacy. Future efforts should prioritize user-centered design, supportive policy development, and comprehensive training programs to facilitate robot adoption and enhance care quality. The protocol was registered with PROSPERO (CRD42024583919). No patient or public contribution was included in this study.

Background Integrated care is a pivotal strategy for addressing global population aging, with its core tenet being “person-centered and demand-driven”. The Chinese government’s “14th Five-Year Plan for National Aging Development” explicitly advocates for the classified development of three types of long-term care facilities (LTCFs): subsistence security-oriented, inclusive support-oriented, and fully market-oriented. However, evidence regarding the integrated care needs of older adults across these distinct institutional models remains scarce, particularly concerning activities of daily living (ADL)-impaired older people. Objectives To investigate the integrated care needs of older people in the above three types of LTCFs and explore the influencing factors of such needs. Methods This multi-centre, cross-sectional,study included 1300 older people from LTCFs. Participants were surveyed using a general information questionnaire and an integrated care needs questionnaire. Multiple linear regression analysis was conducted to identify the factors influencing their integrated care needs. Results Older adults in LTCFs reported moderate-to-high integrated care needs (overall mean ± SD: 3.42 ± 0.62 on a 5-point scale), with the highest demand for basic nursing (3.65 ± 0.72), followed by health guidance (3.58 ± 0.76). Multiple linear regression analysis (adjusted R²=0.512, F = 70.258, p < 0.001) identified ten independent determinants:facility type (public welfare vs. private: β = 0.236, p < 0.001), primary income source,family visit frequency, ADL impairment severity (severe vs. mild: β = 0.332, p < 0.001), chronic disease burden, hospitalization frequency, polypharmacy status, sensory impairment (β = 0.275, p < 0.001), psychological state (poor vs. Good: β = 0.228, p < 0.001), and length of stay. Notably, 89.30% of residents expressed desire for facility-community collaborative care windows. Conclusion Older people in Chinese LTCFs present substantial, multidimensional integrated care needs that vary inversely with facility service capacity. ADL impairment severity, sensory deficits, and psychological distress emerged as the strongest determinants. These findings inform targeted resource allocation and the development of tiered, facility-type-specific integrated care protocols to address the “high age, disability, and chronicity” challenges in institutional aging.

BACKGROUND AND AIM:Population aging exacerbates the public health challenge of cognitive impairment, and frailty, a prominent health problem in the older population, is closely associated with cognitive decline. The aim of this study was to investigate the mechanisms by which frailty affects cognitive functioning in older adults, and to test the chain-mediated effects of sleep quality and depression, as well as the moderating effects of activities of daily living (ADL). METHODS:1645 older adults from 10 communities in Jiangsu Province, China, were surveyed from May to December 2024 using a cross-sectional design. Cognitive function, frailty, sleep quality, depression, and ADL were assessed by the Montreal Cognitive Assessment, FRAIL scale, Pittsburgh Sleep Quality Index, Patient Health Questionnaire, and ADL Scale.Mediating and moderating effects were analyzed using stratified regression modeling and Bootstrap method. RESULTS:Frailty significantly negatively predicted cognitive function (β = -0.278, P < 0.001). Sleep quality (β = -0.129, 95%CI [-0.184, -0.085]) and depression (β = -0.0316, 95%CI [-0.060, -0.005]) partially mediated the association between frailty and cognitive function, and there was a chained mediation effect between the two (β = -0.003, 95%CI [-0.006, -0.0003]). ADL significantly moderated the effect of frailty on cognitive function (interaction term β = 0.036, P = 0.0004), but its moderating effect on the mediating pathway was not significant. CONCLUSIONS:Frailty indirectly impairs cognitive functioning through decreased sleep quality and depressive symptoms, and ADL mitigates the negative effects of frailty. Future interventions need to focus on frailty management, sleep improvement and psychological support, and encourage older adults to participate in daily activities to slow cognitive decline.

BackgroundSocial isolation is a prevalent issue among older people in long-term care facilities (LTCFs), with profound negative impacts on their quality of life and mental health. However, the authentic experiences and underlying mechanisms of social isolation among older people in LTCFs remain understudied. A nuanced understanding of these experiences is essential for designing targeted nursing interventions. ObjectiveThis study aimed to systematically review and synthesize qualitative evidence to explore the experiences of social isolation among older adults in LTCFs and analyze them in terms of causes, mechanisms, outcomes, and strategies. MethodsA systematic review and qualitative meta-synthesis were conducted. We searched PubMed, Web of Science, Embase, PsycInfo, Cochrane Library, CINAHL, Scopus, Chinese Biomedical Literature Database, CNKI, Wanfang Data, and Weipu (VIP) with no restriction on the start year, up to February 2025. Two reviewers (WL and ZM) independently screened studies, extracted data using a Microsoft Excel spreadsheet, and assessed study quality with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Qualitative data synthesis was performed following Thomas and Harden’s thematic and content analysis method, including line-by-line coding of participant quotes, organizing codes into descriptive themes, and developing analytical themes. ResultsA total of 4856 papers were retrieved through systematic searches, and 14 qualitative studies met the inclusion criteria. Four overarching analytical themes were identified: (1) root cause: person-environment mismatch (encompassing 4 interrelated dimensions: imbalance between declining individual capacity and insufficient environmental support, negative self-perception paired with inadequate positive environmental feedback, personal biases conflicting with homogeneous institutional social ecology, and disrupted social roles due to rigid institutional management); (2) overt behavioral patterns: proactive isolation, defensive isolation, and adaptive isolation; (3) inner emotional experiences: feelings of confinement, sorrow, and weariness; and (4) strategies for restoring person-environment match: active engagement in interaction, rational acceptance of coexistence, and passive avoidance and withdrawal. Notably, person-environment mismatch was confirmed as the core mechanism driving the onset and persistence of social isolation in this population. ConclusionsPerson-environment mismatch is the fundamental driver of social isolation among older adults in LTCFs. Interventions should prioritize restoring person-environment alignment—including optimizing physical environments, reconstructing supportive social environments, and enhancing psychological empowerment. Future studies should focus on developing tools to quantify person-environment matching degrees in LTCFs and conduct longitudinal evaluations of targeted interventions to further reduce social isolation and promote active social participation among older people.

IntroductionThe early diagnosis and treatment of mild cognitive impairment (MCI) can help decelerate or even reverse the progression of dementia. Therefore, China attaches great importance to the prevention and control of MCI and has introduced a series of policies.MethodsPolicy themes were identified by pre-processing, vectorizing, and clustering relevant policy texts by using the BERTopic model, and their temporal evolution patterns were revealed through dynamic topic modeling.ResultsCentral-level policies on cognitive impairment prevention and control encompass 12 themes, which can be classified into three major categories: community prevention and early screening, multistakeholder participation in rehabilitation work, and collaborative high-risk chronic disease management. Different work priorities were observed during the initial budding (2005–2018), progressive consolidation (2019–2023), and rapid development (2024–present) stages. Policies consider comorbidity management and demonstrate simultaneous systematization and refinement, with the focus of prevention and control gradually moving forward and responsibilities becoming increasingly diversified. However, issues, such as an underdeveloped comorbidity management system, insufficient coordination between central and local authorities, poor linkage between stages, and inadequate multistakeholder collaboration, persist.Discussion and implicationsIn the future, constructing cognitive impairment prevention and control implementation pathways tailored to local resources; establishing policy transition mechanisms; improving multidepartment and multistakeholder collaboration networks; and enhancing the role of personnel in early screening, rehabilitation interventions, and comorbidity management are necessary to promote effective policy translation and implementation.

With global population aging, cognitive impairment has become a major public health challenge. Current assessment approaches provide important information on cognitive function and disease-related pathology, but offer limited characterization of task-evoked physiological and behavioral responses associated with cognitive impairment. Here, we investigated task-evoked physiological and behavioral responses using a wearable sensing system that synchronously records electroencephalography, electrocardiography, speech, and video signals during structured cognitive tasks. A total of 1,385 community-dwelling adults aged 60 years or older were recruited from five administrative districts in Nanjing, China, and divided into an internal development cohort (n=831) and an external validation cohort (n=554). The system distinguished normal cognition from cognitive impairment, with areas under the receiver operating characteristic curve of 0.93 and 0.90 in the internal and external cohorts, respectively. These findings demonstrate the utility of wearable multimodal signals for accurate assessment of cognitive impairment. Importantly, different cognitive tasks elicit distinct physiological-behavioral features that contribute to cognitive impairment assessment and reflect distinct, complementary cognitive functions. These findings suggest that task-evoked wearable multimodal signals can provide process-level functional phenotyping information for cognitive impairment assessment, complementing conventional cognitive assessment.

AIM:To explore the attitudes and perceptions of Chinese nurses toward robotic health education. BACKGROUND:Nurse shortages have driven the adoption of robotics in clinical health education. However, limited evidence exists on nurses' attitudes and perceptions regarding robotic health education, highlighting the need for further exploration to understand their perspectives on this technology. METHODS:A qualitative interpretive descriptive study using inductive thematic analysis. A total of 28 clinical nurses from tertiary general hospitals in China were interviewed. FINDINGS:Nurses expressed both high expectations and concerns regarding the integration of robotic health education into clinical practice. Three significant themes emerged: (1) Affirming the Future of Robotic Health Education: Coexistence of Expectations and Doubts; (2) Expectations for Robotic Empowerment in Health Education: A Gap Between Technological Aspirations and Practical Realities; and (3) Expectation for Diverse Support in Robotic Health Education: Concerns about the Technology Integration Gap. CONCLUSION:The results indicate that while nurses acknowledge the value of robotic health education, they are also concerned about the technological limitations that may compromise patient safety. Consequently, there is a strong desire for future robotic health education to be more user friendly, intelligent, humanized, and secure. Nurses are particularly eager for robotic health education, under optimal environmental support, to effectively reduce their workload rather than merely serve as a display of technology. IMPLICATIONS FOR NURSING AND NURSING POLICY:These insights reveal both the benefits and challenges of using robotic health education in clinical nursing. The findings guide the optimization of workflows for integrating robots into clinical nursing and inform future technological advancements. Further research is needed to understand the attitudes of a broader range of stakeholders.

Aim: This study aims to ascertain the range of nursing care tasks that can be performed by currently available nursing robots in general adult wards, as well as to quantify the extent to which these robots can potentially replace the nursing care workload when implemented. Background: The global shortage of nurses has emerged as a significant societal issue, and nursing robots may be a potential solution to alleviate this crisis. However, there is a dearth of empirical evidence regarding the specific tasks that nursing robots can effectively replace in general adult wards within hospitals and lacking comprehensive reports that quantify how much nursing workload can be reduced by nursing robots. Methods: This research utilizes a two-phase research design with a scoping review and cross-sectional survey, involving the searching and screening of 10 scientific databases to identify nursing robots suitable for deployment in general adult wards within hospital settings. Additionally, the study measures the 24 h nursing workload for all patients across 72 wards in six hospitals located in eastern, central, and western regions of China. Results: 199 studies were included in this scoping review. A total of 26 nursing functions that can be performed by nursing robots in general adult wards were summarized. 7073 hospitalized patients were included in this study. 26 nursing robots have the potential to substitute for 62.37% of the total nursing workload per capita. Conclusions: The use of nursing robots in general adult wards is promising. However, it is worth noting that while nursing programs with the largest share of nursing workload already have nursing robots in use, there are some robots whose development focus and direction need to be adapted to the needs of the clinical nursing workload. Implications for Nursing Management: It is imperative for nursing managers to receive training in order to increase their understanding of robotic nurses and to explore effective and optimized models for managing nursing human resources when robots and nurses collaborate. Simultaneously, the definition and development of core competencies for robotic specialized nurses need to be on the agenda.

Background:The Namaste Care program is a person-centered intervention that has been shown to improve the quality of life of people with dementia and to alleviate caregiver burden. However, its application in China remains underexplored. Given China's unique sociocultural norms, cultural adaptation is essential to ensure feasibility, acceptability, and contextual fit. Objective:The primary objective is to culturally adapt the Namaste Care Home Program to the Chinese community context. The secondary objective is to evaluate the feasibility and acceptability of the adapted program (qualitative analysis), and to explore its preliminary effects (quantitative analysis) on quality of life and related outcomes for people with dementia and their family caregivers. Methods:A 3-stage, 11-step mixed methods design is used in this study. The process includes a baseline stage for community assessment and stakeholder consultations, a formulation stage for adapting the intervention and training materials, and an execution and evaluation stage in which trained family caregivers deliver the intervention. A 1-group, pretest-posttest design will be used, with quantitative assessments at baseline (T0), immediately after intervention (T1), and at the 3-month follow-up (T2), complemented by qualitative process evaluations. Results:The study was approved in April 2025 (2025-NZY-4-01) and registered on April 18, 2025 (ChiCTR2500101042). Recruitment occurred from January to April 2025, enrolling 15 caregiver-people with dementia dyads. As of April 2025, baseline data collection is complete, and analysis is ongoing. Primary results are expected in mid-2026. Conclusions:The cultural adaptation of the Namaste Care Home Program is a critical step toward advancing person-centered, home-based dementia care in China. Findings will provide evidence on feasibility and cultural appropriateness and will inform the design of future large-scale trials to test effectiveness in cross-cultural settings.

BACKGROUND:Social isolation is a significant challenge for residents in long-term care facilities. This study investigates the risk factors and predictive indicators of social isolation in these settings, aiming to enhance social connections and improve well-being. METHODS:This was a qualitative study. In-depth semi-structured interviews were conducted with participants from 12 long-term care facilities, and the data were analyzed using NVivo 10 software. Inductive analysis was used to identify key themes, which led to the development of a social isolation risk warning model and proposed prevention strategies. RESULTS:A total of 23 participants were interviewed, including 14 managers, 4 head nurses, 2 qualified nurses, and 3 healthcare assistants. In the risk warning model, social isolation risks were categorized into three domains: (1) Social isolation risks and influencing factors: Participants described limited social relationships, restricted social participation, and emotional distress as key risks, further compounded by insufficient family and peer support and weak social interaction skills. (2) Risk consequences and early warning interventions: Social isolation was perceived to contribute to declines in mental well-being and quality of life. Participants emphasized the need for risk assessment, focusing on anxiety、depression and emotional support level. They also highlighted training/education, including theoretical study and contingency plans, and suggested preventive measures such as family members' support and organizing group activities to foster social inclusion. (3) Challenges and solutions: Participants identified concerns about caregiver quality and scarce geriatric care resources as key barriers. They suggested human resource development and national policy support to strengthen workforce capacity and institutional care services. CONCLUSIONS:Social isolation risk assessment plays a pivotal intermediate role in risk prevention. Evaluating relevant risk factors, comprehensive preventive measures could be developed and implemented to reduce the incidence of social isolation. This approach not only improves the psychological well-being of older adults but also enhances the safety and overall quality of care within long-term care facilities. CLINICAL TRIAL NUMBER:SQ2024049. Registered 15th March 2024.

This study sorted out the relevant concepts and their connotations.It reviewed the application of prediction and intervention in the turnover of nurses during the transition period,so as to assist managers in grasping the timing of support for nurses during the transition period,and to provide reference for prospective nursing management.

OBJECTIVES:Our study investigated the association between confidant networks and mortality among older Chinese adults, focusing on the impact of the absence, types, and size of the networks. METHODS:A prospective cohort study included 11,930 participants aged over 65 from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Cox proportional hazards models were employed for analysis, supplemented by subgroup and interaction analyses. RESULTS:Participants without confidant networks had higher mortality (HR=1.194, 95% CI 1.097-1.300) after adjusting for confounders. A dose-response relationship was observed between the size of confidant networks and mortality. Notably, having a spouse as a confidant was strongly associated with decreased mortality (HR=0.765, 95% CI 0.677-0.865), whereas having formal helpers as confidants did not significantly affect mortality (HR=0.813, 95% CI 0.636-1.040). CONCLUSION:Identifying and supporting older adults without confidant networks is crucial for enabling them to benefit from these networks and potentially enhance their longevity.

Cognitive impairment is a common health issue among the elderly, posing significant challenges to society and healthcare resources. Early recognition is a critical strategy for preventing or delaying the onset of cognitive impairment, particularly in cognitive rehabilitation. However, achieving convenient and rapid assessment of cognitive impairment remains a significant challenge. This study proposes a multi-query cross-modal attention fusion model based on synchronized multimodal signals for cognitive impairment recognition. First, we constructed a standardized cognitive impairment assessment dataset (EEV-CI) containing synchronized electroencephalography, electrocardiography, and video signals. Then, a frequency-band adaptive physiological signal encoder was designed to address the pseudo-periodic characteristics. Facial Action Units and emotional states were extracted for facial expression analysis. Finally, themulti-query cross-modal attention mechanism was employed to synchronize and fuse multi-modal signals along the temporal dimension. Experimental results demonstrate that the proposed model achieved superior performance, with 87.01% accuracy, 78.17% F1-macro score, 86.88% AUC and 57.42% MCC. Furthermore, modality-specific experiments demonstrate the unique contribution of each modality to cognitive impairment recognition. These findings further validate the effectiveness of multimodal fusion in cognitive impairment assessment and offer valuable clinical support for rehabilitation.

ObjectiveTo identify potential sleep typing in MCI patients and to explore the characteristics and influencing factors of different sleep typing.MethodsFrom March to December in 2023，community⁃based MCI older adults in Nanjing，Jiangsu Province，China，were enrolled in the study using convenience sampling method.Neuropsychological tests were conducted using the General Information Questionnaire，Montreal Cognitive Assessment Scale（MoCA），Brief Mental State Exercise（MMSE），Ability to Perform Daily Living（ADL），and Clinical Dementia Rating Scale（CDR），and their sleep conditions were assessed and monitored using the Pittsburgh Sleep Quality Index（PSQI） and ActiGraphy.Potential sleep subtypes of MCI patients were identified by latent profile analysis based on objective sleep characteristics monitored by the somatic ActiGraphy as observational variables.Univariate analysis and unordered multicategorical Logistic regression analysis were used to explore the characteristics and influencing factors of different sleep typologies.ResultsA total of 217 MCI patients were recruited in this study，and the results of the potential profiling analysis showed that the sleep of MCI patients could be categorized into four potential categories：sleep deprivation⁃ineffective（31.3%），good sleep（30.0%），sleep fragmentation（27.6%） and difficulty falling asleep（11.1%）.Significant differences were found in gender，family history of dementia，smoking，re⁃employment after retirement，social activities，physical activity，hypertension，and FRAIL and MoCA scores among MCI patients with different sleep typologies（P<0.05）.The results of unordered multicategorical Logistic regression analysis，The results of multicategorical Logistic regression analysis showed that gender，smoking，re⁃employment after retirement，frailty status，and cognitive function were the influencing factors of sleep typing in MCI patients.ConclusionMCI patients' sleep is characterized by significant group heterogeneity.Healthcare professionals should conduct a comprehensive sleep assessment of MCI patients，identify their sleep typing，and adopt targeted sleep management and intervention strategies for different sleep typing in order to improve the sleep status of MCI patients and delay the progression of cognitive decline.

背景  膳食是炎症性肠病（IBD）患者健康管理的关键部分，构建健康膳食推荐模型有助于为IBD患者提供工具，有助于膳食管理和疾病康复。目的  构建成年 IBD 患者健康膳食推荐模型并初步验证。方法  2023 年9月成立研究小组，采用文献研究和德尔菲专家咨询法明确 IBD 患者推荐营养素种类及摄入量，筛选具有抗炎或促炎特性的营养素，采用食物 - 频次矩阵方法识别患者膳食偏好，在此基础上利用多目标优化算法和协同过滤算法建立成年IBD 患者健康膳食推荐模型。采用目的性抽样和最大差异抽样，于 2023 年 12 月选取在南京中医药大学附属南京中医院 IBD 中心就诊的 20 例成年 IBD 患者，运用该模型采用多目标粒子群算法和协同过滤算法为 IBD 患者推荐个性化膳食种类和摄入量，据此验证模型可行性和科学性。结果  成年 IBD 患者健康膳食推荐模型需同时满足营养需求、辅助治疗和膳食偏好三大目标。营养需求主要考虑能量、蛋白质、膳食纤维、维生素 D、钙和铁 6 个指标，辅助治疗从膳食纤维、维生素 A、维生素 C、维生素 E、硒、镁和锌等 7 类抗炎营养素和能量、脂肪、蛋白质和铁等 4 大促炎营养进行综合考量，算法求解得出符合 20 例 IBD 患者膳食偏好的个性化膳食推荐方案。验证结果显示该模型食物种类推荐平均准确率为 95.5%，营养素平均误差为 12.60%。结论  该研究构建的成年IBD患者健康膳食推荐模型准确有效，有助于提升IBD膳食管理精细化。

OBJECTIVES:In order to design targeted interventions, it is necessary to analyze the cognitive function profiles and the factors affecting individuals with mild cognitive impairment. METHODS:From May to August 2022, 389 cases of community-based MCI in older adults were chosen using a stratified convenience sampling method in the Jiangsu Province cities of Nanjing, Changzhou, Nantong, and Xuzhou. The survey was conducted using the following instruments: a general information questionnaire, the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9(PHQ-9), The FRAIL Scale and Activity of Daily Living Scale (ADL). RESULT:Based on the latent profile analysis results, four potential categories for the type of MCI cognitive impairment were identified: high cognition-overall good group (Class 1, n=292, 75.1 %), low cognition-dementia high risk group (Class 2, n=22, 5.7 %), moderate cognition-disorientation group (Class 3, n= 43, 11.1 %), moderate cognition-naming disorder group (Class 4, n=32, 8.2 %). Among people with various subtypes of cognitive function, there were statistically significant distinctions in sex, smartphone use, and frequency of tea consumption (P< 0.05). Considering the high cognition-overall good group as a reference, the multinomial logistic regression analysis's findings showed that smartphone use[ low cognition-dementia high risk group: no, OR=3.177, 95 %CI(1.275, 7.919); moderate cognition-naming disorder group: no, OR=3.035, 95 %CI(1.404, 6.562)] and sex[ moderate cognition-naming disorder group: male, OR=0.311, 95 %CI(0.120, 0.802)] were significant factors in the various cognitive function subtypes of older adults with MCI (P < 0.05). CONCLUSION:The MCI cognitive function subtypes in older adults show significant group variability, and personalized interventions can be used to stop or postpone the onset of dementia in individuals with different subtypes.

BACKGROUND:Spouses often assume the role of primary informal caregivers for ageing partners. Spousal caregivers are more likely than other family members to experience negative psychological outcomes due to their unique identities. However, little is known as to whether psychoeducation interventions can support them in the caregiving process. OBJECTIVES:To systematically identify and synthesise evidence regarding the effects of psychoeducation interventions on psychological outcomes among spousal caregivers of community-dwelling older adults. DESIGN:A systematic review and meta-analysis. METHODS:Eight electronic databases, including Cochrane Library, PubMed, CINAHL, MEDLINE, Embase, PsycINFO, Chinese Journal Net and Wanfang were searched from inception to August 2024. Randomised controlled trials of psychoeducation interventions on psychological outcomes in spousal caregivers of older adults were included. The quality of the evidence was evaluated using The Cochrane Risk of Bias Tool v2. The certainty of the evidence was assessed by the GRADE approach. Data synthesis methods, including meta-analysis and narrative synthesis, were conducted based on data availability. Meta-analysis was performed using a random-effects model given the substantial heterogeneity in the intervention design and outcomes. Sensitivity analyses were used to assess the robustness of the findings. RESULTS:Among the 18 reviewed studies, the overall risk of bias indicated that four had low risk, eight had some concerns, and six had high risk. The pooled analysis suggested that psychoeducation interventions had significant effects on improving marital satisfaction (SMD = 0.28, 95 % CI: 0.09 to 0.47; low certainty) and positive aspects of caregiving (SMD = 1.30, 95 % CI: 0.44 to 2.16; very low certainty). However, the effects on depressive symptoms, caregiving burden, anxiety, mental health, coping and self-efficacy were negligible. Narrative synthesis of evidence suggested potential beneficial effects on posttraumatic growth, family functioning, family relationship and life satisfaction. CONCLUSIONS:Psychoeducation interventions have potential to improve marital satisfaction and positive aspects of caregiving among spousal caregivers of older adults. However, the evidence has a low level of certainty with considerable variability in intervention design and outcome measures, indicating the need for further rigorous investigation. The non-significant effects on enhancing caregiving competence or alleviating negative psychological outcomes highlight the importance of exploring the specific needs and expectations of spousal caregivers. REGISTRATION:PROSPERO (CRD42024498599).

Background: Social isolation is a significant risk factor for depressive symptoms in older adults, with social support and resilience serving as protective factors. However, the mechanisms underlying this association are not well understood. Methods: A cross-sectional survey was performed of 1020 participants (aged >= 60years) in the northern, central and southern parts of Jiangsu Province, China. A general information questionnaire, the Lubben Social Network Scale-6, the Perceived Social Support Scale, the Connor-Davidson Resilience Scale-10, and the Geriatric Depression Scale-5 were used. This study investigated the complex interplay among social isolation, social support, resilience, and depressive symptoms. Using the bootstrapping approach, serial multiple mediation models were constructed to explore the potential serial mediating roles of social support and resilience in the link between social isolation and depression. Results: Lower level of social isolation scores (coefficient = -0.2441, p < 0.001), lower level of social support (coefficient = -0.2368, p < 0.001) and lower level of resilience (coefficient = -0.1594, p < 0.001), were significantly associated with higher level of depressive symptoms. Social support and resilience in serial, mediated the relationship between social isolation scores and depressive symptoms (total effect: coefficient = -0.4526, 95 % CI [-0.0351, -0.0219]; total direct effect: coefficient = -0.2441, 95 % CI [-0.0423, -0.0240]; total indirect effect: coefficient = -0.2085, 95 % CI [-0.2531, -0.1642]). Conclusions: Greater attention should be devoted to enhancing social support for Chinese older adults facing social isolation, which could foster higher resilience to prevent the onset of depressive symptoms. It is critical in driving the progress of mental health among aging community.