Geriatric Nursing最新文献

{"title":"Healthcare-seeking decision-making of individuals with mild cognitive impairment: A concept analysis.","authors":"Yuna Li, Ting Luo, Qing Wang, Xiaofang Liu, Jiangyan Li, Xueshuang Liu, Zhanhui Feng, Zhongchen Luo","doi":"10.1016/j.gerinurse.2026.104414","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104414","url":null,"abstract":"<p><strong>Aim: </strong>To clarify the concept of healthcare-seeking decision-making of individuals with mild cognitive impairment, through the identification of its defining attributes, antecedents, and consequences.</p><p><strong>Design: </strong>Concept analysis guided by the Walker and Avant methodology.</p><p><strong>Methods: </strong>Nine databases (PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CNKI, Wanfang, Sinomed, and VIP) were searched from inception to November 2024. Forty-three articles were included.</p><p><strong>Results: </strong>The defining attributes of healthcare-seeking decision-making of individuals with mild cognitive impairment were symptom perception, decision-making dilemma, decision-making support seeking, decision-making disagreement, decision-making balance, and decision-making resolution. Antecedents were categorized into external antecedents such as medical factors, family support level, and internal antecedents such as cognitive factors and psychological factors. Consequences included positive outcomes such as early recognition and intervention, delayed disease progression, as well as negative outcomes such as progression to dementia and increased psychological stress.</p><p><strong>Conclusion: </strong>This concept analysis provides a comprehensive understanding of healthcare-seeking decision-making of individuals with mild cognitive impairment, highlighting the complex interplay of factors influencing their healthcare choices.</p><p><strong>Implications for nursing practice: </strong>The findings underscore the need for healthcare professionals to recognize and address the multifaceted nature of healthcare-seeking decision-making in mild cognitive impairment individuals, potentially improving timely access to care and health outcomes.</p><p><strong>Impact: </strong>This study addresses conceptual ambiguity surrounding HSDM and provides a theoretical foundation for intervention and instrument development. The framework may support individuals with MCI, families, and healthcare professionals in reducing delays in assessment and informing strategies to improve cognitive healthcare.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104414"},"PeriodicalIF":2.9,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive subtypes of Parkinson's disease patients with cognitive impairment and implications for geriatric nursing interventions: A latent profile analysis.","authors":"Yixuan Hou, Dan Yang, Ping Chen, Yuwei Cao, Jianxin Liu, Chenchen Meng, Xia Liu, Yue Liu, Fan Li, Kai Li, Yunchuang Sun, Jing Chen, Wei Sun, Zhaoxia Wang, Luhua Wei","doi":"10.1016/j.gerinurse.2026.104419","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104419","url":null,"abstract":"<p><strong>Objectives: </strong>To identify cognitive subtypes in Parkinson's disease patients with cognitive impairment (PD-CI) and explore their influencing factors, so as to provide empirical evidence for targeted geriatric nursing interventions.</p><p><strong>Methods: </strong>This cross-sectional study recruited PD-CI patients using convenience sampling from August 2022 to July 2025. Data were collected using a demographic questionnaire, the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III), modified Hoehn and Yahr scale (modified HY), and Activities of Daily Living Scale (ADL). Latent profile analysis (LPA) identified cognitive subtypes, and univariate and multivariate logistic regression explored influencing factors.</p><p><strong>Results: </strong>A total of 246 PD-CI patients were included. LPA identified three cognitive profiles: high cognition-isolated memory decline group (class 1, n=161, 65.4 %), moderate cognition-multi-domain impairment group (class 2, n=64, 26.1 %), low cognition-dementia high risk group (class 3, n=21, 8.5 %).Class 1 had the best overall cognition, with isolated memory decline. Class 2 presented multi-domain impairments (abstraction, memory, visuospatial/executive functions) and significantly worse ADL than Class 1. Class 3 showed the most severe overall cognitive decline, particularly in visuospatial/executive functions and attention, with concurrent ADL and motor deterioration.</p><p><strong>Conclusions: </strong>PD-CI patients show heterogeneous cognitive subtypes with distinct nursing needs. Class 1 requires memory support and safety education; Class 2 needs comprehensive ADL assistance; Class 3 demands proactive integrated management of cognitive, ADL, and motor decline with robust caregiver support. These findings inform personalized geriatric nursing for PD-CI patients.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104419"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet needs and service shortfalls for community-dwelling minority older adults.","authors":"Cynthia Williams","doi":"10.1016/j.gerinurse.2026.104413","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104413","url":null,"abstract":"<p><strong>Introduction: </strong>As the population ages and becomes increasingly diverse, poverty among older adults is also on the rise. Person-Environment (P-E) Fit Theory emphasizes the importance of aligning older adults' needs with the resources available in their communities. This study seeks to identify unmet needs and explore barriers to accessing resources among low-income, minority, community-dwelling older adults in Florida.</p><p><strong>Methods: </strong>Using a mixed-methods design, we administered the Social Needs Screening Tool to community-dwelling older adults and conducted a focus group with community workers who facilitated the survey. Quantitative data were analyzed descriptively, while qualitative data were examined using inductive content analysis.</p><p><strong>Results: </strong>A total of 306 individuals participated in the survey, with an average age of 72 years. Participants were predominantly female (63%) and Black (87.6%). Findings revealed that 70% of uninsured individuals lacked a regular doctor. Additionally, 36% reported food insecurity, 20% faced housing insecurity, and 42% expressed financial concerns. Focus group discussions highlighted themes such as perceived unmet needs, limited available resources, and the importance of building community support networks.</p><p><strong>Conclusion: </strong>This study highlights the role of informal networks and demonstrates the importance of community-based systems in promoting independent living. As the population ages, failing to address social inequities may intensify challenges for vulnerable communities.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104413"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health behaviors and adaptation to chronic illness in relation to successful aging among hospitalized older adults: a cross-sectional study.","authors":"Esra Çavuşoğlu, Neda Heshmati, Melisa Göksal","doi":"10.1016/j.gerinurse.2026.104400","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104400","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine factors associated with successful aging and assess the mediating role of adaptation to chronic illness in the relationship between dietary adherence and successful aging among older adults with chronic diseases.</p><p><strong>Methods: </strong>This cross-sectional study included 414 older adults hospitalized with chronic diseases at a university hospital. Data were collected using a Personal Information Form, Adaptation to Chronic Illness Scale, and Successful Aging Scale. Descriptive statistics, independent samples t-tests, hierarchical regression, Pearson correlation, and mediation analyses were performed. Mediation analysis was conducted using Hayes' PROCESS Model 4 with 5000 bootstrap samples to estimate the indirect effect.</p><p><strong>Results: </strong>Participants had a mean age of 71.9 years; 51% were female and 72.2% married. Bivariate analyses showed that women, married individuals, those with higher education, employed individuals, non-smokers, and those adhering to health-protective behaviors had higher adaptation and successful aging scores. Hierarchical regression showed that demographic variables explained 19% of successful aging, increasing to 44.6% with health behaviors and 47.6% with adaptation to chronic illness. Mediation analysis showed that dietary adherence was indirectly associated with successful aging through adaptation to chronic illness. Adaptation to chronic illness was positively correlated with successful aging (r = 0.619, p < 0.001).</p><p><strong>Conclusions: </strong>Successful aging in older adults with chronic diseases is associated with health-protective behaviors and adaptation to chronic illness. Promoting medication adherence, healthy diet, regular exercise, and routine health check-ups may help nurses and health professionals support adaptation and successful aging.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104400"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conceptualizing longevity in nursing: a multidimensional framework for healthspan optimization.","authors":"Seçil Ergin Doğan, Yasemin Altinbaş","doi":"10.1016/j.gerinurse.2026.104430","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104430","url":null,"abstract":"<p><p>Population ageing has increased the number of years many people live with functional limitation and chronic illness, widening the gap between lifespan and healthspan. Nursing is well positioned to address this gap because nurses repeatedly observe function, symptoms, self-care, behavior, and the fit between a person and the care environment. This narrative review develops the Longevity-Oriented Nursing Framework (LONF), an operational model that links these perspectives without replacing comprehensive geriatric assessment or disease-specific care. Literature was identified through structured searches of PubMed, Scopus, Web of Science, CINAHL, and authoritative organizational repositories, followed by an August 2026 targeted update. LONF organizes practice around five recurring functions: establishing person-prioritized goals and a baseline; assessing intrinsic capacity, functional ability, clinical status, behavior, psychosocial context, and environmental supports; stratifying risk from both current findings and within-person change; delivering nurse-led interventions and coordinating referrals; and monitoring response through in-person and digital follow-up. The framework treats validated functional and patient-reported measures as primary outcomes. Biological-age measures may be documented only as adjunctive, exploratory information because clinical validity, comparability, and action thresholds remain unsettled. Nursing-sensitive indicators are proposed for trajectory surveillance, goal concordance, self-management support, referral closure, safety, equity, and continuity. LONF adds to conventional care by making longitudinal healthspan stewardship explicit and accountable while preserving the established role of geriatric nursing for people with frailty, multimorbidity, disability, and complex care needs. The framework requires prospective feasibility testing, consensus on a core outcome set, and evaluation across diverse health systems before broad implementation.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104430"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of regular exercise and psychoeducation on quality of life, depression, and physical function in older adults with sarcopenia: A single-blind randomized controlled trial.","authors":"Esra Erdoğan, Elif Asan, Mahmut Yaran","doi":"10.1016/j.gerinurse.2026.104415","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104415","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a common geriatric syndrome associated with impaired physical function, depressive symptoms, and reduced quality of life. This trial aimed to compare the effects of exercise alone and exercise combined with psychoeducation on physical function, depressive symptoms, and quality of life in older adults with sarcopenia.</p><p><strong>Method: </strong>Forty older adults aged 60 years and over who were diagnosed with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, who were receiving residential care in a nursing home, and who met the study inclusion criteria were enrolled in the study. Participants were randomly assigned to one of three groups: exercise (E), exercise plus psychoeducation (EP), or control (C). The intervention lasted eight weeks. Functional mobility assessed by the Timed Up and Go (TUG) test was used as the primary outcome measure. Secondary outcomes included handgrip strength, muscle mass assessed by bioelectrical impedance analysis, depressive symptoms assessed by the Geriatric Depression Scale, and quality of life assessed by the SF-12. Outcomes were measured at baseline and post-intervention.</p><p><strong>Result: </strong>Both intervention groups demonstrated significantly greater improvements in functional mobility, depressive symptoms, and quality of life compared with the control group (p < 0.05). Compared with exercise alone, the addition of psychoeducation resulted in greater reductions in depressive symptoms and larger improvements in both physical and mental components of quality of life (p < 0.05).</p><p><strong>Conclusion: </strong>Exercise interventions, particularly when combined with psychoeducation, may represent an effective non-pharmacological approach to improving both physical and psychological outcomes in older adults with sarcopenia.</p><p><strong>Clinical trial numbers: </strong>NCT06868602 / Registration Date: 03/07/2025.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104415"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length of stay by restraint type in hospital dementia care: A retrospective analysis of nursing flowsheet data.","authors":"Clarissa A Shaw, Gregory Isaac, Lisa Weimar, Caitlin Ward","doi":"10.1016/j.gerinurse.2026.104410","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104410","url":null,"abstract":"<p><strong>Background: </strong>Restraint use in hospital dementia care contributes to poor outcomes. De-implementation efforts and national estimates have focused on traditional restraints such as wrist, ankle, and vest. Mitts and geri-chairs are not universally recognized as restraints despite meeting the accepted definition. The objective was to determine the differential impact of restraint types on length of stay in medical-surgical dementia care.</p><p><strong>Methods: </strong>This retrospective analysis used nursing flowsheet data from the electronic medical record at one midwestern United States academic medical center from 2018 to 2022. The sample included 1987 hospitalizations of 1425 patients with dementia on medical-surgical units, excluding emergency, intensive care, and psychiatric units. Restraints were categorized as traditional (wrist, ankle, vest, elbow, belt), non-traditional (mitts, geri-chairs), or no restraints. A linear mixed effects model analyzed the association between restraint type and length of stay adjusting for demographic variables, clinical factors, and nursing care practices.</p><p><strong>Results: </strong>Restraint use occurred in 21.0% of hospitalizations. Non-traditional restraints alone were most common (42.0%), followed by combined use (41.2%) and traditional restraints alone (16.8%); mitts were the most frequently used device (75.1%). Compared with no restraints, stays were 2.52 days longer with non-traditional restraints alone (95% CI=1.56-3.47) and 3.38 days longer with both types (95% CI=2.36-4.41). Non-traditional restraints alone were associated with 1.94 days longer stay than traditional restraints alone (95% CI=0.31-3.57).</p><p><strong>Conclusion: </strong>Non-traditional restraints were the most commonly used restraints in hospital dementia care and were associated with a meaningful impact on length of stay. Greater surveillance and de-implementation efforts are warranted.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104410"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of informal and formal care models at the end of life: An AI-supported systematic review.","authors":"Fangting Ma, Maarten M H Lahr, Erik Buskens, Karin M Vermeulen","doi":"10.1016/j.gerinurse.2026.104417","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104417","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity and functional decline become increasingly prevalent with age, particularly in those near the end of life. This poses critical challenges for both families and society in providing adequate care. However, it remains unclear which type of care yields better outcomes.</p><p><strong>Aim: </strong>To systematically assess the impact of informal care, formal care, and a combination of both on health outcomes, healthcare utilization, and costs of care for older adults near the end of life.</p><p><strong>Design: </strong>A systematic review with narrative synthesis was registered on PROSPERO (CRD42024512003). Screening was assisted by machine learning tool ASReview, and study quality was assessed using the Mixed Methods Appraisal Tool, with support from large language model TXYZ.AI.</p><p><strong>Data sources: </strong>Articles published between database inception and June 4th, 2025 were identified in PubMed, Embase, and CINAHL.</p><p><strong>Results: </strong>Thirty-six studies, including 20 observational and 16 interventional were included. Most observational studies examined place of death, with some associations involving informal care pointing towards lower home death or greater hospital death. In contrast, physician and nurse home visits were associated with a greater likelihood of home death. Specialized formal care interventions generally reported improvements in quality of life and reductions in healthcare use. Quality assessment showed 85.2% AI-human agreement, with 44.4% of studies meeting all seven quality criteria.</p><p><strong>Discussion: </strong>Informal care did not necessarily facilitate home death, whereas formal home-based care was linked to a greater likelihood of home death. Interventional evidence also suggests broader benefits of specialized formal care, although certainty was limited by methodological concerns.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104417"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population aging and nursing regulation: Policy strategies to strengthen the geriatric nursing workforce.","authors":"Sayed Ibrahim Ali, Mostafa Shaban","doi":"10.1016/j.gerinurse.2026.104432","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104432","url":null,"abstract":"<p><strong>Background: </strong>Population aging is increasing demand for nurses prepared to care for older adults. Regulatory frameworks governing nursing education, competence, and workforce standards influence how effectively the nursing workforce can respond to these demographic changes.</p><p><strong>Purpose: </strong>To explore nurses' perceptions of workforce and regulatory challenges affecting the preparation and practice of geriatric nursing.</p><p><strong>Methods: </strong>A qualitative descriptive study, informed by a health-workforce governance perspective and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ), was conducted with 26 registered nurses and nurse leaders working in public teaching hospitals in Al-Ahsa, Saudi Arabia. Semi-structured interviews were conducted and analyzed using reflexive thematic analysis, with sample adequacy guided by the concept of information power rather than data saturation.</p><p><strong>Results: </strong>Three themes emerged: preparing for the complexity of geriatric care, navigating workforce constraints, and interpreting regulatory policies in clinical practice. Participants reported limited geriatric preparation during education, workforce pressures in caring for older adults, and tensions between regulatory expectations and clinical realities.</p><p><strong>Conclusion: </strong>Within this single, resource-constrained academic setting, findings highlight opportunities for regulators and educators to strengthen geriatric competencies, continuing education, and workforce policies to ensure safe, high-quality care for aging populations; the transferability of these insights to other regulatory environments should be examined in future multi-site research.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104432"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The double-edged sword of digital literacy-divergent effects of subjective and objective digital literacy on cognitive health in older adults.","authors":"Chi Zhang, Longxuan Lin, Heyang Zhang","doi":"10.1016/j.gerinurse.2026.104407","DOIUrl":"https://doi.org/10.1016/j.gerinurse.2026.104407","url":null,"abstract":"<p><strong>Aim: </strong>To examine how subjective and objective digital literacy influences cognitive health among older adults.</p><p><strong>Design: </strong>Longitudinal panel study using three waves of nationally representative data.</p><p><strong>Methods: </strong>Fixed-effects models were applied to 19,521 person-year observations of adults aged 60+ from the China Longitudinal Aging Social Survey (2018, 2020, 2023). Cognitive health-a composite of social knowledge, temporal orientation, and mathematical reasoning-was the outcome. Subjective digital literacy was measured by perceived digital ease; objective digital literacy was measured by device proficiency. Mediation and moderation analyses explored mechanisms.</p><p><strong>Results: </strong>Subjective digital literacy (fewer perceived obstacles) predicted better cognitive health (β = -0.009, p < 0.001), largely through social activity participation (12.52% of the total association) and an enhanced sense of social value. Objective digital literacy predicted poorer cognitive health after covariate adjustment (β = -0.015, p < 0.05), through reduced social networks and intergenerational social support. The positive subjective association was stronger in age-friendly communities and among those with chronic diseases or pensions, whereas the negative objective association was weaker where community services were available and stronger in rural areas.</p><p><strong>Conclusion: </strong>Digital literacy showed divergent associations with cognitive health across its subjective and objective dimensions. Given the observational design, causal inference is not warranted.</p><p><strong>Impact: </strong>Digital inclusion strategies that support psychological empowerment while addressing social isolation risks linked to advanced objective digital literacy may help sustain later-life cognitive health.</p><p><strong>Patient or public contribution: </strong>Not applicable.</p>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"74 Pt B","pages":"104407"},"PeriodicalIF":2.9,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}