Comparative characteristics of mental health networks in older adults across care models: A cross-sectional study of community home-based and institutional care.
TL;DR
The home-based network demonstrated good stability, whereas the institutional network's stability was limited by sample size, and these findings highlight the need for personalized, context-specific psychological interventions targeting core symptoms in different care settings.
Abstract
Background
Care models significantly impact older adults' mental health, yet the dynamic interplay among symptoms remains unclear. This study compared the integrated sleep-psychological-social support networks between older adults in community home-based and institutional care.
Methods
We included 973 adults aged ≥ 60 years (home-based: n = 727; institutional: n = 246). Mental health networks were estimated using Gaussian Graphical Models. We evaluated node centrality, bridge expected influence, and assessed between-group differences using the Network Comparison Test (NCT) and stability analyses.
Results
The home-based network was denser (density = 0.576), featuring subjective sleep quality as the core node, with anxiety and life satisfaction acting as key cross-domain bridges. Conversely, the institutional network was sparser (density = 0.348), with core nodes shifting toward objective indicators (e.g., sleep duration) and weakened bridging functions. NCT revealed no statistically significant between-group differences in global strength (p = 0.233) or overall structure (p = 0.124). The home-based network demonstrated good stability, whereas the institutional network's stability was limited by sample size.
Conclusions
Mental health networks differ descriptively across care models. Home-based networks are driven by subjective experiences and show strong cross-domain integration, while institutional networks rely on objective indicators and exhibit modular separation. These findings highlight the need for personalized, context-specific psychological interventions targeting core symptoms in different care settings.