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Mild Behavioral Impairment as a Mediator of the Relationships Among Perceived Stress, Social Support, Physical Activity, and Cognitive Function in Older Adults with Transitional Cognitive Decline: A Structural Equation Modelling Analysis

Published online by Cambridge University Press:  30 July 2025

Wachira Suriyawong ,
Panawat Sanprakhon ,
Noppamas Pipatpiboon ,
Narongkorn Chaiwong ,
Ruksanudt Budda  and
Papan Thaipisuttikul
Wachira Suriyawong
Affiliation:
Faculty of Nursing, https://ror.org/05m2fqn25 Chiang Mai University , Chiang Mai, Thailand
Panawat Sanprakhon*
Affiliation:
Faculty of Nursing, https://ror.org/00x7vzk16Suan Dusit University, Bangkok, Thailand
Noppamas Pipatpiboon
Affiliation:
Faculty of Nursing, https://ror.org/05m2fqn25 Chiang Mai University , Chiang Mai, Thailand
Narongkorn Chaiwong
Affiliation:
Faculty of Nursing, https://ror.org/00cgkxv41 Buriram Rajabhat University , Buri Ram, Thailand
Ruksanudt Budda
Affiliation:
Faculty of Nursing, https://ror.org/05m2fqn25 Chiang Mai University , Chiang Mai, Thailand
Papan Thaipisuttikul
Affiliation:
Faculty of Medicine, https://ror.org/01znkr924Ramathibodi Hospital Mahidol University, Bangkok, Thailand
*
Corresponding author: La correspondance et les demandes de tirésàpart doivent être aressées à:/Correspondence and requests for offprints should be sent to: Panawat Sanprakhon, Faculty of Nursing, Suan Dusit University, Bangkok, Thailand (panawat.san@gmail.com).
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Abstract

Cognitive decline presents individual and societal challenges, underscoring the importance of identifying risk factors to inform interventions for older adults. This cross-sectional study examined how physical activity (PA), perceived stress, and social support were related to cognitive function, with mild behavioral impairment (MBI) as a mediator, among 410 Thai older adults. Structural equation model revealed that perceived stress was associated with increased MBI (p < .001), which was directly related to cognitive function (p < .05). Higher social support was associated with lower MBI (p < .05), while moderate-to-vigorous PA was related to reduced MBI (p < .001) and improved cognitive function (p < .001). MBI mediated the associations of perceived stress (indirect effect = −0.244) and moderate-to-vigorous PA (indirect effect = 0.08) with cognitive function. Perceived stress–MBI relationship was stronger in participants with chronic diseases (∆χ2 = 4.236; p = 0.025). Findings support developing interventions to mitigate MBI, with input from health care professionals.

Résumé

Résumé

Le déclin cognitif présente des défis individuels et sociétaux qui soulignent l’importance de déceler les facteurs de risque afin d’orienter les interventions destinées aux personnes âgées. Cette étude transversale a examiné comment l’activité physique, le stress perçu et le soutien social étaient liés à la fonction cognitive, avec les troubles comportementaux légers (Mild Behavioral Impairment – MBI) comme mesure médiatrice, chez 410 personnes âgées thaïlandaises. La modélisation par équations structurelles a révélé que le stress perçu était associé à une augmentation du MBI (p < 0.001) directement liée à la fonction cognitive (p < 0.05). Un soutien social plus important était associé à un MBI plus faible (p < 0.05), tandis qu’une activité physique modérée à intense était liée à une réduction du MBI (p < 0.001) et à une amélioration de la fonction cognitive (p < 0.001). Le MBI a servi de paramètre médiateur dans les associations du stress perçu (effet indirect = −0.244) et de l’activité physique modérée à intense (effet indirect = 0.08) avec la fonction cognitive. La relation entre le stress perçu et le MBI était plus forte chez les participants atteints de maladies chroniques (∆χ2 = 4.236; p = 0.025). Les résultats soutiennent le développement d’interventions visant à atténuer le MBI, avec la contribution de professionnels de la santé.

Keywords

biopsychosocial modelmild behavioral impairmentstructural equation modellingsubjective cognitive declinemodèle biopsychosocialtroubles comportementaux légersMBImodélisation par équations structurellesdéclin cognitif subjectif

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Canadian Journal on Aging / La Revue canadienne du vieillissement , First View , pp. 1 - 9
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© The Author(s), 2025. Published by Cambridge University Press on behalf of The Canadian Association on Gerontology

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