Comparative characteristics of mental health networks in older adults across care models: A cross-sectional study of community home-based and institutional care.

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.