| Objective1.To investigate the current status and factors influencing cognitive function in community-dwelling older adults with MCI.2.To clarify the associations among cognitive function,resilience,social support,self-efficacy,and depression in community-dwelling older adults with MCI.3.Structural equation model was used to analyze the influencing factors and pathways of cognitive function in community-dwelling older adults with MCI,and to analyze the mediating role and effect of resilience.The results of the quantitative study were also combined to propose recommendations for the health management of cognitive function in community-dwelling older adults with MCI,providing a basis for the development of strategies to improve cognitive function in older adults with MCI.Methods430 elderly people with MCI in 15 communities in Chengdu from February 2022 to December 2022 were selected for the study using a multistage,convenience sampling method,and the general information questionnaire,Montreal Cognitive Assessment(MoCA),Activity of Daily Living Scale,Global Deterioration Scale,10-item ConnorDavidson Resilience Scale,Social Support Rating Scale,The general Self-Efficacy Scale,and 5-Item Geriatric Depression Scale were administered to communitydwelling elderly with MCI.The general data and measurement data of the elderly with MCI were described by mean ± standard deviation,and the counting data of the general data were described by utilization rate and composition ratio.SPSS26.0 was used for data analysis,two independent samples t-test,one-way ANOVA for data that met normal distribution and homogeneity of variance,and further pairwise comparison by LSD test when the difference was statistically significant,and for data that did not meet normal distribution and homogeneity of variance,the Mann-Whitney U test and the Kruskal-Wallis H test were used to evaluate differences in cognitive function levels between different groups.The relationships between cognitive function,resilience,social support,self-efficacy,and depression were analyzed by Pearson correlation analysis.Multiple linear regression analysis was used to explore the factors influencing cognitive function in older adults with MCI.Amos26.0 was used to construct a multifactorial structural equation model of cognitive function in community-dwelling older adults with MCI,and to analyze the effect of various influencing factors on cognitive function and the mediating role of resilience.Results1.The MoCA score of community-dwelling older adults with MCI was(23.06±1.49),and the scores of 7 dimensions were: visuospatial /executive(3.40±0.59),naming(2.91±0.29),attention(3.65±0.52),language(2.66±0.48),abstraction(1.87±0.34),delayed recall(3.47±0.53),and orientation(4.26±0.56).The total score of resilience was(26.53±4.02);the total social support score was(37.39±4.31),and the score of each dimension was(20.38±2.65)for subjective support,(9.17±1.32)for objective support,and(7.84±1.32)for use of social support;the total self-efficacy score was(25.38±3.98);the total score of depression was(1.17±1.18).2.The results of univariate analysis showed statistically significant differences in MoCA scores of older adults with MCI for age,marital status,education level,monthly income,relationship with children,pre-retirement occupation,hours of sleep per day,intensity of usual physical activity,duration of physical activity,frequency of physical activity,and number of chronic conditions(P(27)0.05).3.Pearson correlation analysis showed that cognitive function of older adults with MCI was positively correlated with resilience,social support and self-efficacy;it was negatively correlated with depression.Resilience was positively correlated with social support and self-efficacy;it was negatively correlated with depression(P(27)0.01).4.The results of multiple stepwise linear regression analysis showed that with cognitive function as the dependent variable,age,literacy,relationship with children,duration of physical activity,number of chronic conditions,social support,self-efficacy,depression,and resilience finally entered into the regression equation,and the contribution of the nine independent variables to the variance of cognitive function was82.5%.5.The results of structural equation model analysis showed that five variables,namely cognitive function,resilience,social support,self-efficacy,and depression were used as latent variables to construct the structural equation model,and the results suggested that social support,self-efficacy,and resilience all had direct effects on cognitive function: social support had positive direct effect on cognitive function(β=0.384,P(27)0.001);self-efficacy had positive direct effect on cognitive function(β=0.121,P=0.008);resilience had positive direct effect on cognitive function(β=0.324,P(27)0.001).Resilience had a mediating effect between social support and cognitive function,self-efficacy and cognitive function,depression and cognitive function,with mediation effects of Z=0.152(P=0.003),Z=0.075(P=0.004)and Z=-0.081(P=0.014),respectively,with the mediating effect accounting for 23.7% of the total effect.Conclusions1.The status of cognitive function was relatively well preserved in communitydwelling older adults with MCI.Higher literacy,longer physical activity,higher resilience,adequate social support,and higher self-efficacy were protective factors for cognitive function;older age,poorer relationship with children,more chronic conditions,and depression were risk factors for cognitive function.2.The results of path analysis indicated that social support,self-efficacy,resilience all had direct effects on cognitive function.Social support,self-efficacy,and depression also have indirect effects on cognitive function through the mediation of resilience;resilience effectively plays its mediating role on cognitive function.It is suggested that we should increase and improve the channels and quality of social support,train emotion regulation,cultivate a sense of internal stability,promote cognitive remodeling,and increase coping resources for older adults with MCI to better utilize the resilience to delay cognitive decline and achieve healthy aging. |
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