ArticleFrontiers in public health2025
A mixed-methods study on collaborative health governance for older adults with mild cognitive impairment in Hangzhou, China.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease, poses a critical public health challenge in aging populations. Current community-based MCI interventions are often fragmented, lacking effective collaboration among families, community workers, and physicians. This study aimed to construct a multi-agent collaborative governance model and propose optimization strategies for community-based MCI management. Methods: A mixed-methods design was employed in Hangzhou, China. Quantitatively, 373 community-dwelling older adults with MCI completed the Family APGAR Index, Social Isolation Scale, and Mini-Mental State Examination (MMSE). Structural equation modeling (SEM) was used to analyze the pathways linking social isolation, family support, and cognitive domains. Qualitatively, thematic analysis was conducted on in-depth interviews with four community workers and four family physicians to delineate stakeholder responsibilities and collaboration challenges. Results: The quantitative results revealed a dual effect of family support: it was positively associated with memory and calculation ability (path coefficient = 0.176, Discussion and conclusion: This study underscores the complex role of family support and the necessity of integrated care. We propose a tripartite "Social Worker-Physician-Family" collaborative framework, featuring skill-building curricula, psychological support, and cross-sectoral data linkage protocols to optimize health outcomes. However, due to the cross-sectional design, causal inferences are limited, and longitudinal studies are needed to validate the pathways. The findings offer empirical evidence and practical insights for designing community-based interventions for early-stage cognitive impairment in aging societies.
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