Communication Sciences & Disorders Faculty Publications

Document Type

Article

Publication Date

9-1-2026

Abstract

Background: Care models significantly impact older adults' mental health, yet the dynamic interplay among symptoms remains unclear. This study compared the integrated sleep–psychological–social support networks between older adults in community home-based and institutional care. Methods: We included 973 adults aged ≥ 60 years (home-based: n = 727; institutional: n = 246). Mental health networks were estimated using Gaussian Graphical Models. We evaluated node centrality, bridge expected influence, and assessed between-group differences using the Network Comparison Test (NCT) and stability analyses. Results: The home-based network was denser (density = 0.576), featuring subjective sleep quality as the core node, with anxiety and life satisfaction acting as key cross-domain bridges. Conversely, the institutional network was sparser (density = 0.348), with core nodes shifting toward objective indicators (e.g., sleep duration) and weakened bridging functions. NCT revealed no statistically significant between-group differences in global strength (p = 0.233) or overall structure (p = 0.124). The home-based network demonstrated good stability, whereas the institutional network's stability was limited by sample size. Conclusions: Mental health networks differ descriptively across care models. Home-based networks are driven by subjective experiences and show strong cross-domain integration, while institutional networks rely on objective indicators and exhibit modular separation. These findings highlight the need for personalized, context-specific psychological interventions targeting core symptoms in different care settings.

Comments

http://creativecommons.org/licenses/by-nc-nd/4.0/

Publication Title

International Psychogeriatrics

DOI

https://doi.org/10.1016/j.inpsyc.2026.100269

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