Abstract: Objective To explore the chain-mediated role of social network and self-neglect in the effect of frailty on cognitive function in elderly patients with ischemic stroke. Methods With convenience sampling, 383 elderly ischemic stroke patients from 2 hospitals of different grades (1 tertiary grade-A hospital and 1 tertiary grade-B hospital) in Yangzhou City from October 2022 to November 2023 were selected as the study subjects, and were investigated by using the General Information Questionnaire, Chinese version of the Tilburg Frailty Scale, Lubben Social Network Scale, the Scale of Elderly Self-Neglect, and Montreal Cognitive Assessment Scale to construct and validate the chained mediation model. Results The incidence of frailty and impaired cognitive functioning in this group of elderly patients with ischemic stroke was 64.0% and 85.9%, respectively. The score of total social network and self-neglect was 16.14±6.67 and 15.61±6.92, respectively. There were correlations between each pair of the four variables: frailty, social network, self-neglect, and cognitive functioning. The indirect effect of frailty on cognitive function in elderly ischemic stroke patients was established, with a total indirect effect of 36.8%; the specific mediating effect of social network accounted for 11.1% of the total indirect effect; that of self-neglect accounted for 21.7% of the total indirect effect; and the chain mediating effect of social network and self-neglect between frailty and cognitive function accounted for 5.2%. Conclusion Multiple mediating effects of social network and self-neglect between frailty and cognitive function are established. Healthcare professionals should proactively assess the degree of frailty in elderly ischemic stroke patients. Strengthened social networks, reduced self-neglect, and improved cognitive function are beneficial for improving the quality of patients' survival quality.

Key words: elderly individual, ischemic stroke, frailty, social network, self-neglect, cognitive function