ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1677690
This article is part of the Research TopicNutrition in Neurodegeneration: Bridging Diet, Brain, and Eye HealthView all 3 articles
The longitudinal mediating effect of life-space mobility on the relationship between nutritional status and cognitive function in community-dwelling older stroke patients
Provisionally accepted
- 1Harbin Medical University, Harbin, China
- 2Daqing Longnan Hospital, Daqing, China
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Abstract Objectives: This study aims to explore the causal relationship between nutritional status, life-space mobility (LSM), and cognitive function in community-dwelling older stroke patients, investigate the longitudinal mediating role of life-space mobility in the relationship between nutritional status and post-stroke cognitive function. Methods: A total of 284 ischemic stroke patients aged ≥60 years were recruited from the neurology inpatient department of a tertiary hospital, with follow-up assessments conducted at 3-, 6-, and 9- months post-stroke. Mini Nutrition Assessment-Short Form (MNA-SF) were used to assess nutritional status, the Life Space Assessment (LSA-C) was used to measure life-space mobility and the global cognitive function was assessed with the Mini Mental State Examination (MMSE). Linear mixed-effects model and cross-lag-panel model was applied to examine the longitudinal relations among the variables. Results: LMM analysis revealed a significant total effect of nutritional status on post-stroke cognitive function (Estimate = 0.026, 95%CI [0.022, 0.030], p < 0.001). A significant indirect effect through LSM was identified (Estimate = 0.006, 95% CI [0.004, 0.008], p < 0.001), accounting for 24.94% of the total effect. After controlling for the longitudinal influence of LSM, the direct effect remained significant (Estimate = 0.019, 95%CI [0.015, 0.023], p < 0.001), indicating a partial mediating role of LSM. In contrast, the CLPM revealed a complete mediation effect for the T2-T3 pathway, with a significant indirect effect (β = 0.029, 95%CI [0.004, 0.061], p<0.05) and a non-significant direct effect, providing complementary evidence for the mediating role of life-space mobility through a different analytical approach. Conclusions: In the chronic rehabilitation phase of older stroke patients, malnutrition can indirectly influence the development or exacerbation of post-stroke cognitive impairment via limited life-space mobility. This underscores the importance for early malnutrition identification and intervention and life-space mobility improvement to enhance long-term cognitive function in post-stroke care.
Keywords: Stroke, older adults, Nutritional Status, Life-space mobility, Cognitive Function, activity
Received: 01 Aug 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Lei, Bai, Kang, Xin, Li, Yang, Li and Meng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lina Meng, 8449969@qq.com
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