{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:51:55Z","timestamp":1792036315462,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The fragmentation of the US healthcare system imposes a high cognitive burden on older adults. Coordinated Care (CC) is hypothesized to improve patient outcomes, but the relationship between multidimensional CC experiences and cognitive aging remains unclear. We investigated whether experiences across three domains of CC (perceived CC, tangible support, and technical support) are associated with cognitive trajectories and incident cognitive impairment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Data were drawn from the Health and Retirement Study (2016\u20132022), including the 2016\n CC<\/jats:styled-content>\n module (\n N<\/jats:italic>\n \u2009=\u20091321; aged \u2265\u200950). Baseline\n CC<\/jats:styled-content>\n was assessed via three patient\u2010reported scales: perceived\n CC<\/jats:styled-content>\n (provider communication consistency, 0\u201320 scale), tangible support (family\/professional assistance with medical tasks, 0\u201311 scale), and technical support (patient portal offered and used, 0\u20134 scale). Cognitive function was measured biennially (2016\u20132022) using the 27\u2010point Telephone Interview for Cognitive Status (\n TICS<\/jats:styled-content>\n ). Incident cognitive impairment was defined as the first follow\u2010up score of \u2264\u200911 among those cognitively normal at baseline. Linear mixed\u2010effects models estimated 6\u2010year cognitive trajectories, and Cox proportional hazards models assessed risk of incident impairment.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In fully adjusted models, higher perceived\n CC<\/jats:styled-content>\n (\n \u03b2<\/jats:italic>\n \u2009=\u20090.25,\n p<\/jats:italic>\n \u2009<\u20090.05) and technical support (\n \u03b2<\/jats:italic>\n \u2009=\u20090.22,\n p<\/jats:italic>\n \u2009<\u20090.05) were associated with higher baseline cognitive scores. Greater tangible support was associated with lower baseline cognition (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.48,\n p<\/jats:italic>\n \u2009<\u20090.001) but also with slower cognitive decline over time (interaction\n \u03b2<\/jats:italic>\n \u2009=\u20090.005,\n p<\/jats:italic>\n \u2009<\u20090.05). Tangible support was associated with higher risk of impairment in unadjusted analyses (\n HR<\/jats:styled-content>\n \u2009=\u20091.26), but this association was not statistically significant after adjustment.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Implications<\/jats:title>\n Perceived CC and technology use characterized cognitively robust older adults, whereas tangible support identified vulnerable individuals yet was associated with slower cognitive decline. These findings underscore the need for nuanced CC strategies: digital tools engage those aging well, while intensive tangible support may be especially important for those with greater vulnerabilities. These associations are observational and do not establish causality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.70797","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:42:07Z","timestamp":1792035727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coordinated Care Experience in Late\u2010Life and Cognitive Aging of Older Adults in the United States: A Longitudinal Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3958-8609","authenticated-orcid":false,"given":"Xiang","family":"Qi","sequence":"first","affiliation":[{"name":"Rory Meyers College of Nursing New York University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8353-9696","authenticated-orcid":false,"given":"Renhao","family":"Li","sequence":"additional","affiliation":[{"name":"Rory Meyers College of 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