{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:07:09Z","timestamp":1784696829055,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Objective<\/jats:title>\n To investigate the changes, bidirectional relationships, and moderating factors of illness perception and intrinsic capacity in older adults with COPD and Type 2 Diabetes Mellitus (T2DM) during the hospital-to-home transition.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective cohort study was conducted from April 2024 to September 2025, conveniently enrolling 232 older adults with COPD and T2DM from the Sixth People\u2019s Hospital of Nantong. Participants were assessed at three time points: at discharge (T0), 1\u202fmonth (T1), and 3\u202fmonths (T2) post-discharge, using the Brief Illness Perception Questionnaire (BIPQ) and a WHO framework-based intrinsic capacity assessment tool. A Random-intercept cross-lagged panel model (RI-CLPM) was used to analyze the dynamic cross-lagged relationships, a Latent growth model (LGM) was used to analyze the association of their change trajectories, and exploratory subgroup analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n (1) Trajectory analysis: Illness perception total scores showed a consistent and significant decreasing trend across the three time points (\n p<\/jats:italic>\n &lt;\u202f0.001), while intrinsic capacity total scores exhibited a slight but significant linear decline (\n p<\/jats:italic>\n =\u202f0.010). (2) Dynamic associations: The RI-CLPM revealed significant bidirectional negative associations between illness perception and intrinsic capacity during the T0-to-T1 phase (\n \u03b2<\/jats:italic>\n =\u202f\u22120.21,\n \u03b2<\/jats:italic>\n =\u202f0.18, both\n p<\/jats:italic>\n &lt;\u202f0.05). During the T1-to-T2 phase, only intrinsic capacity was positively associated with subsequent higher negative illness perception (\n \u03b2<\/jats:italic>\n =\u202f0.15,\n p<\/jats:italic>\n =\u202f0.047). (3) Trajectory association: The parallel process LGM indicated a moderate-to-strong positive correlation between the rate of improvement in illness perception and the rate of decline in intrinsic capacity (\n r<\/jats:italic>\n =\u202f0.32,\n p<\/jats:italic>\n =\u202f0.008). (4) Subgroup differences: Exploratory analyses showed that COPD severity (GOLD stage 3\u20134) and impaired baseline vitality significantly strengthened the negative association between illness perception and intrinsic capacity (between-group comparison\n p<\/jats:italic>\n &lt;\u202f0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n During the hospital-to-home transition, illness perception and intrinsic capacity in older adults with COPD and T2DM exhibit a dynamic interaction, characterized by bidirectional influences in the early stage and a more sustained effect of intrinsic capacity on perception later. COPD severity and baseline vitality status are important clinical moderators of this relationship. The findings provide a basis for developing targeted transition care strategies that integrate psychological and functional interventions for high-risk subgroups.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1896128","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:44:49Z","timestamp":1784695489000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The interaction between illness perception and intrinsic capacity during hospital-to-home transition in older adults with COPD and diabetes: a prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xinjing","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Tuberculosis, The Sixth People's Hospital of Nantong","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, The Sixth People's Hospital of Nantong","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijuan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The Sixth People's Hospital of Nantong","place":["Nantong, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Disease and Intensive Care Medicine, Nanjing Gaochun People's Hospital","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1809","DOI":"10.3390\/jcm14061809","article-title":"Chronic obstructive pulmonary disease and type 2 diabetes mellitus: complex interactions and clinical implications","volume":"14","author":"Anghel","year":"2025","journal-title":"J Clin Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2343364","DOI":"10.1080\/13814788.2024.2343364","article-title":"Effectiveness of the assessment of burden of chronic conditions (ABCC)-tool in patients with asthma, COPD, type 2 diabetes mellitus, and heart failure: a pragmatic clustered quasi-experimental study in the Netherlands","volume":"30","author":"Boudewijns","year":"2024","journal-title":"Eur J Gen Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e43729","DOI":"10.1097\/MD.0000000000043729","article-title":"Assessment of the effect of home health care services on emergency department admissions in geriatric patients: a cross-sectional observational study","volume":"104","author":"Ayyildiz","year":"2025","journal-title":"Medicine"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1177\/1357633X231174488","article-title":"Effectiveness of a home-based telesurveillance program in reducing hospital readmissions in older patients with chronic disease: the ecobahlt randomized controlled trial","volume":"31","author":"Tchalla","year":"2025","journal-title":"J Telemed Telecare"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1080\/09638288.2024.2384624","article-title":"Experiences with hospital-to-home transitions: perspectives from patients, family members and healthcare professionals. 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