Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"How Does NIL Policy Impact the Well-Being of College Athletes and Beyond: A Multi-Stakeholder Perspective.","authors":"Sarah Xuan Guo, Rose Chepyator-Thomson, Shelby N Glasgow, James J Zhang, Yi Zhang","doi":"10.1177/00469580261484287","DOIUrl":"10.1177/00469580261484287","url":null,"abstract":"<p><p>IntroductionThis study examines the multifaceted impacts of the NCAA's NIL (Name, Image, and Likeness) policy, which became effective on June 30, 2021, on the psychological well-being of Division I college athletes. The policy permits athletes to earn income from their NIL contracts, creating new roles as brand ambassadors and increasing the commercial use of social media. However, this expanded freedom can compound existing mental health challenges-including anxiety, stress, and burnout-that stem from athletic and academic commitments.MethodsEmploying semi-structured interviews with 14 Division I student-athletes and grounded in the Social Identity Model of Transition (SIMOT), this study examines how athletes navigate a triple identity (student, athlete, influencer), the relational environments in which NIL-related pressures are experienced, and the role of institutional support in shaping well-being outcomes.ResultsFindings reveal that NIL functions both as a source of motivation and a trigger for psychological strain, mediated primarily by social media demands, unequal access to NIL opportunities, and inconsistent institutional support.ConclusionSports psychologists and counselors working with student-athletes should be attentive to NIL-related stressors as a distinct and contemporary source of identity strain, role overload, and social media anxiety, and clinical assessments for this population should include questions about NIL engagement, social media management burden, and perceived inequality relative to teammates. At the institutional level, athletic departments should integrate mental health literacy into NIL orientation programs, ensuring that athletes can identify stress responses and seek support before distress escalates into more serious psychological difficulty. Notably, it is necessary to reiterate that the findings of this study only reflect Division I athlete experiences, and studying other competition levels is highly suggested.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261484287"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Global Research on Adverse Effects of GLP-1 Receptor Agonists (2006-2025): A Scopus-Based Bibliometric and Thematic Analysis.","authors":"Riad Mohammed Abdelrahman, Taha Hussein Musa, Ismail Adam Arbab, Eltieb Omer Ahmed, Sahar Ibrahim Gasmallah, Mohammed Jalal, Wafaa Ramadan Ahmed, Khalid Hamid Fadul","doi":"10.1177/00469580261441498","DOIUrl":"10.1177/00469580261441498","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for managing type 2 diabetes and obesity. As their clinical applications expand, interest in their safety and adverse effects has grown. This study provides a comprehensive bibliometric analysis of global research trends, collaboration patterns, and thematic evolution on GLP-1RA-related adverse effects from 2006 to 2025. This study is a bibliometric analysis. Data were extracted from the Scopus database and analyzed using Bibliometrix (R package) and VOS viewer. Indicators assessed included publication and citation metrics, institutional productivity, and keyword co-occurrence and mapping. Correlations were evaluated using Pearson and Spearman tests, and the Durbin-Watson statistic was applied to assess the independence of residuals. A total of 1075 articles published in 389 journals were identified, authored by 6068 researchers across 85 countries. The annual growth rate was 32.06%, with no single-author papers and 34.23% international co-authorship, indicating strong global collaboration. The United States (30.5%), the United Kingdom (10.6%), and Denmark (7.8%) led in publication output and total citations. Institutional analysis identified Novo Nordisk A/S (60 papers, 11 207 citations) and Eli Lilly & Co. (45 papers, 9948 citations) as the most influential contributors. Diabetes, Obesity and Metabolism published the most articles (n = 106), followed by Diabetes Care and The Lancet Diabetes & Endocrinology. Significant correlations were found between article count and h-index (<i>r</i> = .677, <i>P</i> < .001) and total citations (<i>r</i> = .779, <i>P</i> < .001). Keyword analysis revealed 2 main thematic clusters-one pharmacological (drug safety, efficacy, liraglutide, semaglutide) and 1 clinical (human, male, female, adult)-with an emerging focus on population-specific safety since 2021. Research on GLP-1RA-related adverse effects has expanded rapidly, shaped by strong international collaboration and industry-academic partnerships. Future efforts should prioritize balanced global participation, real-world safety data, and mechanistic insights to inform clinical practice and pharmacovigilance.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261441498"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Easy Life or Chaos?\": Older Adults' Digital Experiences, Well-Being, and Patterns of Engagement: A Qualitative Study.","authors":"Hanife Akgül, Gülşah Yıldırım, Mustafa Mayda","doi":"10.1177/00469580261466645","DOIUrl":"10.1177/00469580261466645","url":null,"abstract":"<p><p>IntroductionDigital technologies have become integral to everyday life; however, older adults' engagement remains uneven. This study aimed to explore how older adults interpret digital technologies and make sense of their digital experiences, with particular attention to how these experiences relate to well-being in later life.MethodsThis qualitative study adopted a phenomenological orientation. Semi-structured, face-to-face interviews were conducted with 22 adults aged 65 and over in Türkiye. Participants were selected using maximum variation and snowball sampling strategies to ensure diversity. Data were analyzed using an inductive thematic approach.ResultsFive interrelated themes were identified: meanings attributed to digital, digital experiences (facilitators and barriers), impacts on well-being, coping and adaptation strategies, and needs in digital processes. Digital engagement was experienced as both enabling and constraining. Facilitating experiences supported social connection, daily functioning, and health-related practices, while barriers included limited digital literacy, economic constraints, and experiences of ageism. These experiences generated cognitive, behavioral, and emotional impacts, ranging from autonomy, engagement, and satisfaction to fear, withdrawal, dependence, and reduced confidence. Importantly, emotional responses functioned as mechanisms shaping patterns of engagement or avoidance. Participants adopted both self-directed and support-seeking coping strategies and emphasized educational, technical, and social needs for meaningful digital participation.ConclusionDigital engagement in later life is a dynamic process shaped by structural, emotional, and social factors. Digital inclusion should be addressed as a determinant of well-being, requiring integrated approaches that combine digital literacy training, age-friendly design, and socially supportive environments.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261466645"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Do-Not-Resuscitate Decisions in Critically Ill Patients Through Using Multitask Learning: A Retrospective Study of the MIMIC-IV Database.","authors":"Ming-Yen Lin, Chuan-Feng Yeh, Wen-Cheng Chao","doi":"10.1177/00469580261420721","DOIUrl":"10.1177/00469580261420721","url":null,"abstract":"<p><p>Timely identification of critically ill patients for do-not-resuscitate (DNR) decisions is crucial to support shared decision-making and ethical end-of-life care. This study developed an explainable multitask learning (MTL) model using the MIMIC-IV database to predict the DNR decision within 24 h. The model was trained on data from 7789 adult patients who were admitted to the intensive care units (ICUs) with a length of stay longer than 3 days, using features including clinical parameters and nursing assessments across a 72-h window. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC), calibration plots, and decision curve analysis. Interpretability was illustrated by SHapley Additive exPlanations (SHAP) plots and partial dependence plots (PDP). Error analysis was performed to explore the strengths and limitations of the established model. The MTL model achieved superior performance compared to single-task learning (AUROC: 0.798 vs 0.764). SHAP and PDP plots demonstrated that verbalization ability, ventilatory support, and muscle strength as key features. Error analysis identified a subgroup of patients with extreme ventilatory demand and muscle weakness who contributed to misclassification; excluding this subgroup improved AUROC from 0.792 to 0.827. We developed a DNR prediction model and demonstrated the feasibility of integrating an explainable model into ICU care for a nudge to consider the DNR-relevant issue.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261420721"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focusing on the III Strategic Priority of National Action Plan on Antimicrobial Resistance Through the Baseline Assessment of Indicators of Infection Prevention and Control in a Provincial Hospital in Nepal: A Quality Improvement Project.","authors":"Nabin Pathak, Prerana Shrestha, Shreya Dhungana, Sachita Barma, Sujil Manandhar, Prabhat Kumar Jha, Subash Karki, Surendra Dev Badu, Prashant Bidari, Sunil Shrestha","doi":"10.1177/00469580261463905","DOIUrl":"10.1177/00469580261463905","url":null,"abstract":"<p><p>IntroductionInfection Prevention and Control (IPC) is a science-based, practical approach that protects patients and healthcare workers by reducing hospital-associated infections (HAIs) and tackling antimicrobial resistance (AMR). The study aims to assess the baseline status of IPC in a provincial hospital in Nepal to help propose an action plan for implementation and mitigate the burgeoning issue of AMR.MethodA cross-sectional study was conducted as a quality improvement project at one of the provincial hospital of Nepal using the structured World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool to perform a baseline assessment. The IPCAF tool's 8 core components and 81 indicators were assessed to determine the hospital's IPC status and to propose an action plan to facilitate IPC-related activities. After receiving the data, it was entered into MS Excel 2013, analyzed for the indicator scores, and visualized using R Version 4.5.2.ResultThe total score for the eight basic IPC indicators was 397.5/800, indicating that the facility operated at a \"basic\" IPC level (score range: 201-400). The highest score was in Monitoring/audits of IPC practices and feedback (77.5), indicating relative strength. Moderate scores were seen in IPC programme (60) and IPC guidelines (62.5), followed by HAI surveillance (55) and IPC education and training (50). Three indicators scored below 50, indicating poor adherence to the international guideline (IPCAF) and critical gaps that underscore the need for urgent attention.ConclusionThis first IPC assessment at one of the provincial hospital revealed a \"Basic\" IPC status, highlighting critical gaps in areas like Multimodal strategies, workload, staffing and bed occupancy, resources, materials, and equipment for IPC, and IPC education and training. Despite a few strengths, the findings call for an urgent, time-limited, and team-based approach with effective implementation and ongoing monitoring of the IPC action plan.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261463905"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Knowledge of Pelvic Floor Disorders and Its Determinants in the Gurage Zone, Central Ethiopia: A Community-Based Cross-Sectional Study.","authors":"Tolesa Gemeda Gudeta, Ayele Sahile Abdo, Aberash Beyene Derribow, Hirut Dinku Jiru, Ayana Benti Terefe, Girma Teferi Mengistu, Seboka Abebe Sori, Mangistu Abera","doi":"10.1177/00469580261467460","DOIUrl":"10.1177/00469580261467460","url":null,"abstract":"<p><p>IntroductionPelvic floor disorders (PFDs) are common conditions that negatively affect women's quality of life, particularly in low-resource settings where awareness is often limited. Although knowledge of PFDs remains low in many developing settings, evidence from Ethiopia is limited, and the extent and determinants of women's knowledge have not been well explored. Therefore, this study aimed to assess the knowledge of pelvic floor disorders and its determinants among women in Gurage Zone, Central Ethiopia.MethodsA community-based cross-sectional study design was utilized, employing a multistage sampling technique to select 844 women. Data were collected through face-to-face, interviewer-administered questionnaires. The data were entered into EpiData version 3.1 and exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were used to identify factors associated with knowledge of pelvic floor disorders (PFDs). Statistical significance was declared at a p-value of less than 0.05 with a 95% confidence interval (CI).ResultsIn this study, the overall prevalence of women's knowledge of pelvic floor disorders was found to be 40.5% (95% CI: 37.1, 43.7). Higher educational status (AOR = 3.28; 95% CI: 2.02, 7.54), being an urban resident (AOR = 2.51; 95% CI: 1.37, 14.03), being multiparous (AOR = 2.43; 95% CI: 1.08, 5.47), being grand multiparous (AOR = 4.21; 95% CI: 1.81, 11.1), and having awareness of pelvic organ prolapse (POP) as a medical condition (AOR = 2.91; 95% CI: 1.57, 5.40) were identified as determinants of women's knowledge of pelvic floor disorders.ConclusionOnly two in five women were knowledgeable about PFD in this study area, which is considered low. These findings underscore the need for targeted educational interventions to bridge knowledge gaps, particularly among populations with lower educational attainment and those living in rural areas.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261467460"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Devices and Better Health: Positive Associations Between Smart Devices and Health Among Older Adults.","authors":"Yuanyang Wu, Shuyu Dong, Huimin Zhou, Xiaodong Li, Conghui Ma","doi":"10.1177/00469580261447172","DOIUrl":"10.1177/00469580261447172","url":null,"abstract":"<p><p>IntroductionSmart devices hold significant value for enhancing the health of older adults by promoting healthcare utilization and supporting chronic disease prevention.MethodsThis study investigates the relationship between smart device usage and health status among older adults, along with the underlying mechanisms, using panel data from the 2018 and 2020 waves of the China Longitudinal Aging Social Survey (CLASS). The baseline analysis employs a Two-Way Fixed Effects model to estimate the relationship between smart device usage and multiple health indicators. To ensure robustness, we further conduct instrumental variable estimation and exclude specific interfering samples. Additionally, heterogeneity across demographic subgroups is examined using interaction-term-based split-sample regression.ResultsUse of smart wristbands is associated with better self-rated health (SRH), lower depression scores, and higher social adaptation. Smart assistants and audiobooks are also associated with better social adaptation. Overall, smart devices enhance health by increasing healthcare utilization, encouraging social participation, strengthening social support, and facilitating early diagnosis of chronic diseases. These effects vary notably across gender, marital status, residence, age, and education level. Moreover, smart device use is linked to a pronounced reduction in medical expenditures.ConclusionThe findings reveal a positive association between smart device use and health outcomes among older adults, indicating the important role of smart devices in supporting health management and alleviating medical burdens among older adults. This study provides empirical evidence for promoting digital health interventions and suggests that policy efforts should consider demographic differences to enhance the equitable adoption of smart technologies.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Neutrophil Percentage-To-Albumin Ratio With All-Cause and Cardiovascular Mortality in Chronic Kidney Disease.","authors":"Yingying Wu, Siqi Ding","doi":"10.1177/00469580261450864","DOIUrl":"10.1177/00469580261450864","url":null,"abstract":"<p><p>IntroductionThis research sought to understand the relationship of the neutrophil percentage-to-albumin ratio (NPAR) and mortality from cardiovascular (CVD) and all causes in populations with CKD.Methods7,553 CKD patients were included and grouped into quartiles based on NPAR. Kaplan-Meier curves were utilized for survival analysis, while a multivariate Cox proportional hazards model calculated the risk ratio of NPAR on CVD and all-cause mortality. The potential linear connection of NPAR with CVD/all-cause mortality was analyzed through restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) analysis was used to assess predictive performance. Subgroup analysis was executed with stratification according to demographic characteristics.ResultsThe Kaplan-Meier curve indicated that a higher NPAR was linked to a greater risk of CVD/all-cause mortality (<i>p</i> < 0.0001). In fully adjusted models, a one-unit rise in NPAR correlated with a 185% rise in the likelihood of dying from CVD diseased (HR = 2.85, 95% CI 2.26-3.47) and a 154% rise in the likelihood of dying from any cause (HR = 2.54, 95% CI 2.22-2.91). A non-linear link for NPAR and CVD/all-cause mortality was validated through RCS analysis, with a <i>P</i> value <0.001. ROC analysis showed that NPAR had modest discriminative ability for predicting all-cause mortality (AUC = 0.601), with an optimal cutoff value of 1.48. Across different subgroups, NPAR reliably predicted CVD and all-cause mortality in CKD patients.ConclusionElevated NPAR were linked with a higher likelihood of CVD mortality and all-cause mortality in patients with CKD and could serve as an effective prognostic biomarker.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability and Employment Inclusion in a Transforming Economy: Epidemiological Evidence from National Survey Data.","authors":"Abdullah Alduais, Ahmed Alduais","doi":"10.1177/00469580261441064","DOIUrl":"10.1177/00469580261441064","url":null,"abstract":"<p><p>Employment inclusion for persons with disabilities is a critical public-health and social-justice priority. In Saudi Arabia, the intersection of disability, gender, and national reform under Vision 2030 presents unique challenges and opportunities for equitable labour participation. This study examined employment patterns, structural determinants, and potential policy pathways to enhance inclusion among Saudis with disabilities. A cross-sectional analytical design was applied using nationally representative data from the 2017 Saudi Disability Survey (n = 1 312 261 working-age individuals). Employment status served as the dependent variable, while severity, difficulty scope, sex, marital status, and access to Ministry of Labor and Social Development (MLSD) services were predictors. Weighted descriptive statistics and grouped logistic regression were used to identify correlates of employment, followed by counterfactual simulations estimating potential gains under alternative policy scenarios. National employment among persons with disabilities was 18.5%, with pronounced disparities by gender and severity. Men were 2.6 times more likely than women to be employed (AOR = 2.64, <i>P</i> < .001). Each severity level reduced employment odds by ≈40%, while MLSD service access modestly improved inclusion (AOR = 1.21). Married individuals showed higher participation (AOR = 1.32). Simulations projected that integrated policies combining expanded service coverage and gender-targeted incentives could raise employment inclusion by ≈5% points. Employment inclusion in Saudi Arabia remains strongly shaped by gender and functional severity, with institutional services offering limited but positive effects. Findings highlight the need for multi-sectoral strategies-linking rehabilitation, workplace accessibility, and gender-equity reforms-to advance national inclusion goals. The 2017 survey provides a baseline for evaluating Vision 2030 reforms and future longitudinal assessments of disability employment.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261441064"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Social Frailty With Incident Dementia and Cognitive Decline in Middle-Aged and Older Adults: A Prospective Cohort Study.","authors":"Qian Chen, Nian Tang","doi":"10.1177/00469580261468818","DOIUrl":"10.1177/00469580261468818","url":null,"abstract":"<p><p>IntroductionSocial frailty is a multidimensional construct encompassing social behaviors, social resources, and the fulfillment of basic social needs, and is increasingly recognized as an important factor influencing cognitive function. This study aimed to evaluate the association between social frailty and incident dementia as well as changes in cognitive function among middle-aged and older adults, providing novel evidence through a longitudinal cohort applying a multidimensional social frailty framework.MethodsData were derived from the China Health and Retirement Longitudinal Study (CHARLS). Social frailty was defined across four dimensions: general resources, social behavior, social resources, and basic social needs. Cognitive function was assessed using tests of memory, orientation, and executive function. Cox proportional hazards models were used to analyze the association between social frailty and incident dementia, and linear mixed-effects models were applied to examine the relationships between social frailty and changes in overall and domain-specific cognitive function.ResultsCompared with the socially robust group, the socially frail group showed an increased risk of incident dementia in Model 1 and Model 3 (HR = 2.42, 95% CI: 1.50-3.89, P < 0.001; HR = 1.52, 95% CI: 0.92-2.53, P = 0.102, respectively). Among the dimensions, only the social behavior dimension remained significantly positively associated with dementia risk (HR = 1.38, 95% CI: 1.11-1.73, P = 0.004). Regarding cognitive function changes, social frailty was significantly associated with decline in overall cognitive function (β = -0.12, 95% CI: -0.18 to -0.06, P < 0.001), primarily reflected in memory decline (β = -0.14, 95% CI: -0.21 to -0.08, P < 0.001), whereas no significant associations were observed for orientation or executive function.ConclusionSocial frailty is associated with a higher risk of incident dementia and faster cognitive decline, highlighting its potential as an early and modifiable risk marker for cognitive aging.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261468818"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}