{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:33:30Z","timestamp":1787765610044,"version":"build-2784847793"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify heterogeneous profiles of self-neglect (ESN) and their associated factors among rural Chinese older adults with chronic diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 719 rural older adults with chronic diseases in Sichuan, China, from January to June 2020. The questionnaire included sociodemographic and health-related characteristics, as well as the Three-Item UCLA Loneliness Scale (UCLALS-3), the Social Support Rating Scale (SSRS), the Scale of Older Adults Self-Neglect (SESN), the Five-Item Geriatric Depression Scale (GDS-5), and the Short Portable Mental Status Questionnaire (SPMSQ). Latent profile analysis (LPA) was conducted to identify distinct patterns of patterns of self-neglect among older adults (ESN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four profiles were identified: low-level neglect (35.0%), selective mild neglect (37.7%), moderate neglect (14.7%), and severe neglect (12.5%). Compared with the low-level neglect group, selective mild neglect was more common among participants with poorer economic status, poor sleep quality, and alcohol consumption. The moderate neglect profile was associated with older age, lack of regular physical examinations, smoking, pain, cognitive impairment, and lower social support. Severe neglect was marked by the absence of grandchild caregiving, higher loneliness, smoking, and depression. Pairwise comparisons indicated stage-dependent patterns, with reversed associations for social support (protective in moderate neglect but a risk marker in severe neglect) and pain (a risk factor in moderate neglect, whereas its absence indicated higher risk in severe neglect).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ESN among older adults with chronic diseases in rural China is heterogeneous and comprises distinct latent profiles with stage-dependent risk factors. For selective mild neglect, interventions should emphasize economic and lifestyle support. For moderate neglect, priorities include routine monitoring, regular physical examinations, and health literacy promotion. For severe neglect, intensive psychosocial interventions should address depression and loneliness and promote alternative engagement in family roles, particularly among older adults who do not provide grandchild caregiving. Integrating these profile-specific strategies into rural primary care may help reduce self-neglect and improve health outcomes in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1738418","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:43:06Z","timestamp":1769582586000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Latent profile analysis of self-neglect and associated factors among rural older adults with chronic diseases: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zihan","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Nursing, People\u2019s Hospital of Deyang City","place":["Deyang, China"]},{"name":"School of Nursing, Southwest Medical University","place":["Luzhou, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengchuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zikejimu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, People\u2019s Hospital of Deyang City","place":["Deyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoxiang","family":"You","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, People\u2019s Hospital of Deyang City","place":["Deyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Ju","sequence":"additional","affiliation":[{"name":"School of Nursing, Southwest Medical University","place":["Luzhou, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College","place":["Chengdu, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e11129","DOI":"10.1016\/j.heliyon.2022.e11129","article-title":"Multiple chronic conditions among older adults in China: differences in socio-demographic characteristics","volume":"8","author":"Liu","year":"2022","journal-title":"Heliyon"},{"key":"ref2","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"287","DOI":"10.5582\/bst.2019.01213","article-title":"China has faster pace than Japan in population aging in next 25 years","volume":"13","author":"Chen","year":"2019","journal-title":"Biosci Trends"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1126\/science.1209396","article-title":"China\u2019s demographic history and future challenges","volume":"333","author":"Peng","year":"2011","journal-title":"Science"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1038\/s41586-023-05738-w","article-title":"Ageing threatens sustainability of smallholder farming in China","volume":"616","author":"Ren","year":"2023","journal-title":"Nature"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.2147\/IJGM.S309783","article-title":"Prevalence and patterns of comorbidity among middle-aged and elderly people in China: a cross-sectional study based on CHARLS data","volume":"14","author":"Fan","year":"2021","journal-title":"Int J Gen Med"},{"key":"ref7","year":"2023"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.3390\/ijerph17051609","article-title":"What happens to the health of elderly parents when adult child migration splits households? Evidence from rural China","volume":"17","author":"Li","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.geoforum.2013.04.013","article-title":"Ageing, migration and familial support in rural China","volume":"51","author":"Liu","year":"2014","journal-title":"Geoforum"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"654627","DOI":"10.3389\/fmed.2021.654627","article-title":"Development of a conceptual framework for severe self-neglect (SN) by modifying the CREST model for self-neglect","volume":"8","author":"Pickens","year":"2021","journal-title":"Front Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"103396","DOI":"10.1016\/j.gerinurse.2025.103396","article-title":"Prevalence and influencing factors of self-neglect in older adults: a systematic review and meta-analysis","volume":"64","author":"Li","year":"2025","journal-title":"Geriatr Nurs N Y N"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"949","DOI":"10.2147\/CIA.S103359","article-title":"Elder self-neglect: research and practice","volume":"12","author":"Dong","year":"2017","journal-title":"Clin Interv Aging"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1017\/S1041610217000229","article-title":"Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study","volume":"29","author":"Zhao","year":"2017","journal-title":"Int Psychogeriatr"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2534","DOI":"10.1093\/jn\/136.10.2534","article-title":"Nutritional status is altered in the self-neglecting elderly","volume":"136","author":"Smith","year":"2006","journal-title":"J Nutr"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1177\/0733464817714565","article-title":"Medication regimen complexity and low adherence in older community-dwelling adults with substantiated self-neglect","volume":"38","author":"Abada","year":"2019","journal-title":"J Appl Gerontol Off J South Gerontol Soc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1159\/000360698","article-title":"Elder self-neglect is associated with an increased rate of 30-day hospital readmission: findings from the Chicago health and aging project","volume":"61","author":"Dong","year":"2015","journal-title":"Gerontology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1080\/08946566.2025.2478384","article-title":"Prevalence and associated risk factors of elder self-neglect among community-dwelling older adults in Turkey","volume":"37","author":"\u00d6zmete","year":"2025","journal-title":"J Elder Abuse Negl"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e12591","DOI":"10.1111\/opn.12591","article-title":"Urban-rural differences in associations among perceived stress, resilience and self-care in Chinese older adults with multiple chronic conditions","volume":"19","author":"Jin","year":"2024","journal-title":"Int J Older People Nursing"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1080\/08946566.2024.2389389","article-title":"Neighborly relations and self-neglect in older adults living alone: a cross-sectional study in rural areas of Southwest China","volume":"36","author":"Jia","year":"2024","journal-title":"J Elder Abuse Negl"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1186\/s12889-025-22778-1","article-title":"Self-neglect, frailty and depression among older women living in southern T\u00fcrkiye","volume":"25","author":"U\u00e7an Yama\u00e7","year":"2025","journal-title":"BMC Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e13059","DOI":"10.1111\/ijn.13059","article-title":"Exploring perceived challenges of self-management in low-income older people with hypertension: a qualitative study","volume":"28","author":"Zhang","year":"2022","journal-title":"Int J Nurs Pract"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"13857","DOI":"10.1038\/s41598-024-64314-y","article-title":"Mindfulness and self-regulation intervention for improved self-neglect and self-regulation in diabetic older adults","volume":"14","author":"Motamed-Jahromi","year":"2024","journal-title":"Sci Rep"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"115","DOI":"10.2190\/AG.78.2.b","article-title":"Prevalence and risk factors for self-neglect among older adults living alone in South Korea","volume":"78","author":"Lee","year":"2014","journal-title":"Int J Aging Hum Dev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1186\/s12877-024-05558-1","article-title":"Prevalence of self-neglect and related factors among older adults living in Western Turkey: a cross-sectional study","volume":"24","author":"Ayaz","year":"2024","journal-title":"BMC Geriatr"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1111\/jgs.12832","article-title":"Four subtypes of self-neglect in older adults: results of a latent class analysis","volume":"62","author":"Burnett","year":"2014","journal-title":"J Am Geriatr Soc"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1037\/met0000486","article-title":"Ten frequently asked questions about latent transition analysis","volume":"28","author":"Nylund-Gibson","year":"2023","journal-title":"Psychol Methods"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1111\/2047-3095.12503","article-title":"The prevalence of self-neglect among older adults: a systematic review and meta-analysis","author":"Mao","year":"2025","journal-title":"Int J Nurs Knowl"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e332","DOI":"10.3346\/jkms.2018.33.e332","article-title":"The association between frequency of social contact and frailty in older people: Korean frailty and aging cohort study (KFACS)","volume":"33","author":"Chon","year":"2018","journal-title":"J Korean Med Sci"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1093\/ije\/dys078","article-title":"Sedentary behaviour and cardiovascular disease: a review of prospective studies","volume":"41","author":"Ford","year":"2012","journal-title":"Int J Epidemiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"6645","DOI":"10.3390\/ijerph10126645","article-title":"Prevalence of sedentary behavior in older adults: a systematic review","volume":"10","author":"Harvey","year":"2013","journal-title":"Int J Environ Res Public Health"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A short scale for measuring loneliness in large surveys: results from two population-based studies","volume":"26","author":"Hughes","year":"2004","journal-title":"Res Aging"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1526569","DOI":"10.3389\/fpsyt.2025.1526569","article-title":"Loneliness among dementia caregivers: evaluation of the psychometric properties and cutoff score of the three-item UCLA loneliness scale","volume":"16","author":"Ali","year":"2025","journal-title":"Front Psychol"},{"key":"ref33","first-page":"98","article-title":"The theoretical basis and research application of social support rating scale","volume":"4","author":"Xiao","year":"1994","journal-title":"J Clin Psychiatry"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1111\/j.1532-5415.1999.tb03848.x","article-title":"Development and testing of a five-item version of the geriatric depression scale","volume":"47","author":"Hoyl","year":"1999","journal-title":"J Am Geriatr Soc"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1532-5415.1975.tb00927.x","article-title":"A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients","volume":"23","author":"Pfeiffer","year":"1975","journal-title":"J Am Geriatr Soc"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1126\/science.847460","article-title":"The need for a new medical model: a challenge for biomedicine","volume":"196","author":"Engel","year":"1977","journal-title":"Science"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"S271","DOI":"10.1111\/j.1532-5415.2008.01980.x","article-title":"Elder self-neglect: a discussion of a social typology","volume":"56","author":"Paveza","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"ref38","first-page":"542","volume-title":"Nursing: Concepts of practice","author":"Orem","year":"2001"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000364933","article-title":"Aging as a process of deficit accumulation: its utility and origin","volume":"40","author":"Mitnitski","year":"2015","journal-title":"Interdiscip Top Gerontol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"2292","DOI":"10.1111\/j.1532-5415.2010.03156.x","article-title":"Decline in cognitive function and risk of elder self-neglect: finding from the Chicago health aging project","volume":"58","author":"Dong","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.archger.2016.01.007","article-title":"Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population","volume":"64","author":"Dong","year":"2016","journal-title":"Arch Gerontol Geriatr"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1186\/s12889-024-18029-4","article-title":"Nature, prevalence, and risk factors for self-neglect among older people: a pilot study from Vellore","volume":"24","author":"Devaraj","year":"2024","journal-title":"South India BMC Public Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"736688","DOI":"10.3389\/fnhum.2022.736688","article-title":"Chronic pain in the elderly: mechanisms and perspectives","volume":"16","author":"Dagnino","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/j.2161-0029.2015.00033.x","article-title":"Etiology and management of elder self-neglect","volume":"14","author":"MacLeod","year":"2015","journal-title":"Adultspan J"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1111\/j.1532-5415.2007.01629.x","article-title":"Healthcare costs and utilization of vulnerable elderly people reported to adult protective services for self-neglect","volume":"56","author":"Franzini","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1177\/0271678X241270415","article-title":"Tobacco cigarette smoking induces cerebrovascular dysfunction followed by oxidative neuronal injury with the onset of cognitive impairment","volume":"45","author":"Ewees","year":"2025","journal-title":"J Cereb Blood Flow Metab Off J Int Soc Cereb Blood Flow Metab"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.tins.2021.09.006","article-title":"Alcohol and the brain: from genes to circuits","volume":"44","author":"Egervari","year":"2021","journal-title":"Trends Neurosci"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"105564","DOI":"10.1016\/j.jpain.2025.105564","article-title":"High-impact pain predicts subjective cognitive decline and interacts with APOE4 genotype in the development of objective cognitive impairment","volume":"37","author":"Tamargo","year":"2025","journal-title":"J Pain"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1498283","DOI":"10.3389\/fpain.2024.1498283","article-title":"Correlates of neurocognitive performance in older adults with chronic pain and negative emotions: baseline data from the problem adaptation therapy for pain (PATH-pain) randomized controlled trial","volume":"5","author":"Mindlis","year":"2024","journal-title":"Front Pain Res Lausanne Switz"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"e0180222","DOI":"10.1371\/journal.pone.0180222","article-title":"Association between elder abuse and poor sleep: a cross-sectional study among rural older Malaysians","volume":"12","author":"Yunus","year":"2017","journal-title":"PLoS One"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1590\/S1980-5764-2016DN1003004","article-title":"Sleep and executive functions in older adults: a systematic review","volume":"10","author":"Holanda","year":"2016","journal-title":"Dement Neuropsychol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"e84232","DOI":"10.7759\/cureus.84232","article-title":"The role of sleep and the effects of sleep loss on cognitive, affective, and behavioral processes","volume":"17","author":"Hyndych","year":"2025","journal-title":"Cureus"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1111\/ggi.13169","article-title":"Health checkup behavior and individual health beliefs in older adults","volume":"18","author":"Okura","year":"2018","journal-title":"Geriatr Gerontol Int"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/j.jagp.2020.02.004","article-title":"Quality and quantity of social support show differential associations with stress and depression in African Americans","volume":"28","author":"Benca-Bachman","year":"2020","journal-title":"Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"5085","DOI":"10.3390\/ijms25105085","article-title":"Chronic stress-induced neuroinflammation: relevance of rodent models to human disease","volume":"25","author":"White","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1081559","DOI":"10.3389\/fpsyg.2023.1081559","article-title":"Grandchild care and life satisfaction of older adults: empirical evidence from China","volume":"14","author":"Dong","year":"2023","journal-title":"Front Psychol"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1080\/13607863.2025.2460068","article-title":"Quantity and quality of social relationships and their associations with loneliness in older adults","volume":"29","author":"Norlin","year":"2025","journal-title":"Aging Ment Health"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1037\/0003-066X.54.3.165","article-title":"Taking time seriously. A theory of socioemotional selectivity","volume":"54","author":"Carstensen","year":"1999","journal-title":"Am Psychol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1038\/s41398-022-02292-3","article-title":"The neurobiology of apathy in depression and neurocognitive impairment in older adults: a review of epidemiological, clinical, neuropsychological and biological research","volume":"12","author":"Steffens","year":"2022","journal-title":"Transl Psychiatry"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/d41586-024-00900-4","article-title":"Why loneliness is bad for your health","volume":"628","author":"Sidik","year":"2024","journal-title":"Nature"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1002\/gps.2420","article-title":"Self-neglect and cognitive function among community-dwelling older persons","volume":"25","author":"Dong","year":"2010","journal-title":"Int J Geriatr Psychiatry"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1093\/ageing\/afi202","article-title":"Medication management at home: medication-related risk factors associated with poor health outcomes","volume":"34","author":"Sorensen","year":"2005","journal-title":"Age Ageing"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1738418\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:16:27Z","timestamp":1771924587000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1738418\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":62,"alternative-id":["10.3389\/fpubh.2026.1738418"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1738418","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]},"article-number":"1738418"}}