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

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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.
Funding Information
  • Ministry of Higher Education, Science, Research and Innovation, Thailand (FF67-193078)

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