{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:37:17Z","timestamp":1793090237386,"version":"4.5.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,11]]},"abstract":"\n Background<\/jats:title>\n Alzheimer's disease is associated with progressive cognitive decline and impaired activities of daily living. Professional institutional care and family home care are common long-term care models, but their associations with patient outcomes and potential mediating pathways remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the associations of care model with cognitive function and activities of daily living in patients with mild-to-moderate Alzheimer's disease and to assess the mediating roles of neuropsychiatric symptoms and social support.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This cross-sectional study included 309 patients: 194 receiving professional institutional care and 115 receiving family home care. Cognition, daily functioning, neuropsychiatric symptoms, and social support were assessed using standardized scales. Multiple linear regression, propensity score matching, bootstrap mediation analysis, and subgroup analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n After full adjustment, professional institutional care was associated with higher Montreal Cognitive Assessment scores (\u03b2=1.87, 95% confidence interval [CI] 0.87\u20132.87; p\u2009<\u20090.001) and lower Activities of Daily Living scores (\u03b2=\u22123.04, 95% CI \u22125.16 to \u22120.92; p\u2009=\u20090.005). Propensity score matching yielded consistent results. Neuropsychiatric symptoms mediated 22.37% of the association with daily functioning, whereas social support did not show a significant mediating effect. Associations were consistent across subgroups.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Professional institutional care was associated with better cognition and greater independence in daily living, partly through fewer neuropsychiatric symptoms. Because of the cross-sectional design, these findings do not establish causality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/13872877261488017","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:06:14Z","timestamp":1789740374000},"page":"297-307","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between caregiving status and cognitive function as well as activities of daily living among community-dwelling older adults with Alzheimer's disease: A cross-sectional study"],"prefix":"10.1177","volume":"114","author":[{"given":"Ruzhao","family":"Li","sequence":"first","affiliation":[{"name":"Qilu Hospital of Shandong University Dezhou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2530-9627","authenticated-orcid":false,"given":"Binbin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Qiao","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University Dezhou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University Dezhou Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. 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Reliability and validity of the Beijing version of the Montreal cognitive assessment in the evaluation of cognitive function of adult patients with OSAHS. 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