{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:26:49Z","timestamp":1784071609745,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102410\u2010H\u2010038\u2010010"],"award-info":[{"award-number":["NSTC 112\u20102410\u2010H\u2010038\u2010010"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102410\u2010H\u2010007\u2010048"],"award-info":[{"award-number":["NSTC 112\u20102410\u2010H\u2010007\u2010048"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 113\u20102314\u2010B\u2010038\u2010080\u2010MY3"],"award-info":[{"award-number":["NSTC 113\u20102314\u2010B\u2010038\u2010080\u2010MY3"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102410\u2010H\u2010468\u201001\u2010SSS"],"award-info":[{"award-number":["NSTC 112\u20102410\u2010H\u2010468\u201001\u2010SSS"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102410\u2010H\u2010038\u2010014"],"award-info":[{"award-number":["NSTC 112\u20102410\u2010H\u2010038\u2010014"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prevalence of dementia has been increasing, and communication difficulties among people with cognitive impairment are burdensome and frustrating for both older adults and caregivers. However, subjective communication difficulties have rarely been examined in the context of communication as a two\u2010way interaction. The purpose of this study was to examine communication difficulties among older adults with various degrees of cognitive impairment and to explore related factors and their associations with quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional survey study, face\u2010to\u2010face interviews were conducted to collect data from older adults aged 50 years or older with various degrees of cognitive impairment in the community (hospitals or daycare centers) or in long\u2010term care institutions. In total, 133 people were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five dimensions of communication difficulties were extracted via a factor analysis: communication stress, wording difficulties, negative interactions, family\/friend chatting, and family\/friend adaptations. Family\/friend adaptation difficulties were related to a lower likelihood of having a good quality of life (odds ratio = 0.562,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). Greater total communication difficulties were related to a diagnosis of dementia (B = 2.991;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05), subjective memory complaints (B = 2.562;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05), and lower social support (B = \u22121.064;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Among the dimensions of communication difficulties, communication stress and wording difficulties were related to cognitive function\u2010related variables, whereas negative interactions, family\/friend chatting, and family adaptations were related to social support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older adults may care more about negative interactions and how family\/friends interact with them than about cognitive difficulties, and social support is essential for reducing communication difficulties. Caregivers should learn how to interact with people with cognitive impairment to reduce difficulties and the burden of caregiving.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71372","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T06:34:20Z","timestamp":1775543660000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Communication Difficulties Among Older Adults With Different Degrees of Cognitive Impairment"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-2480","authenticated-orcid":false,"given":"Hui\u2010Chuan","family":"Hsu","sequence":"first","affiliation":[{"name":"School of Public Health Taipei Medical University  New Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4658-1088","authenticated-orcid":false,"given":"Chyi\u2010Huey","family":"Bai","sequence":"additional","affiliation":[{"name":"School of Public Health Taipei Medical University  New Taipei Taiwan"},{"name":"Department of Public Health School of Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-0946","authenticated-orcid":false,"given":"Shu\u2010Nu","family":"Chang\u2010Lee","sequence":"additional","affiliation":[{"name":"Department of Long\u2010Term Care National Quemoy University  Kingmen Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8291-0603","authenticated-orcid":false,"given":"Jiun\u2010Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration Asia University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-2184","authenticated-orcid":false,"given":"Sheng\u2010Feng","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4090-5483","authenticated-orcid":false,"given":"Yi\u2010Wen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering National Tsing Hua University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12559"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12738"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607860120080332"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12485"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02687038.2019.1608502"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2010.02971.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1471301220962235"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1044\/2022_AJSLP\u201021\u201000266"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2016.11.017"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2018.1446513"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2005.53221.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580211028181"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2019.1667296"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1024\/1421\u20100185\/a000242"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2019.1694116"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/60.1.S48"},{"key":"e_1_2_12_18_1","unstructured":"Taiwan 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