Unraveling the Link: How Loneliness Shapes the Relationship Between Autonomy Participation and Mild Cognitive Impairment in Stroke Patients

Unraveling the Link: How Loneliness Shapes the Relationship Between Autonomy Participation and Mild Cognitive Impairment in Stroke Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Unraveling the Link: How Loneliness Shapes the Relationship Between Autonomy Participation and Mild Cognitive Impairment in Stroke Patients Chunxia Zhao, Fang Fu, Tanghua Dai, Tian Zhan, Yan Wu, Xiaoqun Fang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7108707/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Stroke, a leading cause of global mortality and disability, often results in post-stroke cognitive impairment, which significantly affects survivors and increases the risk of dementia. Loneliness and reduced autonomous participation are common among post-stroke patients, yet their relationship with mild cognitive impairment remains underexplored. This cross-sectional study of 285 stroke patients assessed cognitive function, autonomous participation, and loneliness, using mediation analysis to examine their interrelationships. The findings revealed that risk factors for mild cognitive impairment included older age, chronic diseases, longer disease duration, memory decline, and loneliness, while autonomous participation was found to be protective. Significant correlations were observed: higher autonomous participation correlated with lower mild cognitive impairment (r = -0.384, P < 0.01) and lower loneliness (r = -0.394, P < 0.01), while loneliness was positively correlated with mild cognitive impairment (r = 0.431, P < 0.01). Mediation analysis identified loneliness as a partial mediator between autonomous participation and mild cognitive impairment, suggesting that addressing loneliness may improve cognitive outcomes in post-stroke patients. The study highlights loneliness’s mediating role in the autonomous participation-mild cognitive impairment relationship, suggesting clinical interventions targeting loneliness, particularly in low-autonomy patients, may mitigate cognitive decline. Limitations include single-center sampling and cross-sectional design, necessitating future longitudinal studies. These findings underscore the need for integrated care strategies addressing psychosocial and functional factors to improve post-stroke outcomes. Health sciences/Diseases Health sciences/Health care Health sciences/Neurology Biological sciences/Neuroscience Biological sciences/Psychology Social science/Psychology Sroke mild cognitive impairment autonomous participation loneliness Full Text Additional Declarations No competing interests reported. Supplementary Files supplementarytable1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 10 Apr, 2026 Editor invited by journal 23 Jul, 2025 Editor assigned by journal 22 Jul, 2025 Submission checks completed at journal 19 Jul, 2025 First submitted to journal 19 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7108707","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":622226127,"identity":"963cc759-0b27-4ae5-b17a-a1ee05be3b9f","order_by":0,"name":"Chunxia Zhao","email":"","orcid":"","institution":"Nanchang University","correspondingAuthor":false,"prefix":"","firstName":"Chunxia","middleName":"","lastName":"Zhao","suffix":""},{"id":622226128,"identity":"4ef27fbd-4ee8-4c35-afe7-a3c801c9673a","order_by":1,"name":"Fang Fu","email":"","orcid":"","institution":"Nanchang 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Loneliness and reduced autonomous participation are common among post-stroke patients, yet their relationship with mild cognitive impairment remains underexplored. This cross-sectional study of 285 stroke patients assessed cognitive function, autonomous participation, and loneliness, using mediation analysis to examine their interrelationships. The findings revealed that risk factors for mild cognitive impairment included older age, chronic diseases, longer disease duration, memory decline, and loneliness, while autonomous participation was found to be protective. Significant correlations were observed: higher autonomous participation correlated with lower mild cognitive impairment (r = -0.384, P \u003c 0.01) and lower loneliness (r = -0.394, P \u003c 0.01), while loneliness was positively correlated with mild cognitive impairment (r = 0.431, P \u003c 0.01). Mediation analysis identified loneliness as a partial mediator between autonomous participation and mild cognitive impairment, suggesting that addressing loneliness may improve cognitive outcomes in post-stroke patients. The study highlights loneliness’s mediating role in the autonomous participation-mild cognitive impairment relationship, suggesting clinical interventions targeting loneliness, particularly in low-autonomy patients, may mitigate cognitive decline. Limitations include single-center sampling and cross-sectional design, necessitating future longitudinal studies. 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