Supporting the Conditions for Healthy Cognitive Aging in Place Through Integrated Care: A Retrospective Qualitative Case Study with a Longitudinal Documentary Component.

Aging in place (AiP) and healthy cognitive aging (HCA) are closely interrelated concepts but seldom examined together within real-world care systems. Integrated care (IC) offers a framework to understand how community settings can support both. This qualitative case study examined a 25-year-old community-based integrated health and social care program in a rural Czech microregion. Utilizing a realist-informed context-mechanism-outcome framework, the study integrated data from documentary analysis, semistructured interviews, and participant observation. The findings suggest that the conditions facilitating AiP and HCA may be mutually supported through interrelated, context-dependent, cumulatively operated mechanisms, including environmental predictability, continuity of care, coordination across services, social embeddedness, supported autonomy, and reductions in cognitive and organizational burden and stress. IC is not a direct intervention, but acts as a context-dependent moderator that shapes the conditions for AiP and HCA. Behaviorally, these mechanisms minimize decision-making complexity and establish predictable interaction patterns that support everyday functioning. AiP and conditions relevant to HCA are mutually supported through shared underlying mechanisms embedded in care systems and community contexts. IC may facilitate this by fostering stable, person-centered environments that may reduce cognitive demands and support relational continuity. The study contributes to behavioral science by exploring how IC may shape conditions relevant to cognitive and functional outcomes in later life and provides actionable insights for the design of IC systems.