SOCIAL SUPPORT, FAMILY CONNECTION, AND MENTAL HEALTH AMONG INSTITUTIONALIZED OLDER ADULTS IN VIETNAM: A CROSS-SECTIONAL STUDY

DOI: https://doi.org/10.26758/16.1.38

Hanoi Medical University, Vietnam. Ph.: (+84) 0936 11 0129, Email: nguyenthihue@hmu.edu.vn. https://orcid.org/0009-0004-6866-7212

 Abstract

Objectives: This study describes the characteristics of social support and mental health status among institutionalized older adults and examines the association between social support—specifically perceived social support and frequency of family contact—and mental health outcomes, including stress, anxiety, depression, and cognitive function.

Materials and methods: Data from 196 older adults residing in a nursing home in Hanoi, Vietnam, were analyzed using multivariate linear regression to examine associations between social support and mental health indicators.

Results: Perceived social support was significantly associated with lower stress, anxiety, and depression scores. For cognitive function (MMSE), frequency of family contact remained a significant predictor (β = .59 for very frequent contact, p < .001), whereas perceived social support was not significantly associated with MMSE scores, suggesting that structural aspects of social connection may be more relevant to cognitive outcomes than subjective appraisal of support.

Conclusions: Greater perceived social support and more frequent family contact were associated with better mental health among institutionalized older adults, with perceived support most strongly associated with depression and stress, and family contact frequency uniquely associated with cognitive function. These findings, while preliminary given the cross-sectional design, small single-site sample, and reliance on self-report, point to the value of psychosocial support programs and meaningful family engagement in nursing home care.

Keywords: nursing homes; mental health; older adults; perceived social support; cognitive function

Suggested citation (APA):

Nguyen, H. T. (2026). Social support, family connection, and mental health among institutionalized older adults in Vietnam: A cross-sectional study. Anthropological Researches and Studies, 16, 598-609. https://doi.org/10.26758/16.1.38

Introduction

The growing elderly population, expected to account for approximately 25% by 2040 in some regions, underscores the urgency of effective mental health interventions (Paiva et al., 2023). The mental health of older adults is an increasing concern, as this population commonly experiences depression, dementia, anxiety, and social isolation, all of which contribute to psychological morbidity (Albert & Kornadt, 2022; Dijin, 2023). The prevalence of mental and neurological disorders among older adults is expected to rise further, underscoring the need for greater awareness of their mental health needs (Javed, 2022). A range of factors is associated with the mental health of older adults, including demographic characteristics, medical conditions, and environmental factors (Shafiyeva et al., 2023). Building on this evidence, this study aimed to examine the association between social support—specifically frequency of family contact and perceived social support—and mental health outcomes, including stress, anxiety, depression, and cognitive function, among older adults living in residential care facilities.

Mental health is central to the well-being of older adults, as it is linked to disability, health care outcomes, and quality of life (Kehn et al., 2023). Depression, anxiety, and dementia are among the most common mental health problems in this population and may be compounded by factors such as social isolation and public health crises (Puglia, 2022).

Family plays an important role in the mental health of older adults, particularly those residing in nursing homes. Family is often the primary source of emotional, practical, and financial support for older adults, despite the challenges posed by social and economic change (Minh & Huong, 2021). In rural settings, family support has been associated with fewer depressive symptoms, whereas domestic violence has been associated with greater depression (Do et al., 2022). During the COVID-19 pandemic, family relationships were closely linked to mental health: family conflict was associated with increased depression, anxiety, and stress, while emotional expression within the family was associated with lower levels of these problems (Rajkumar, 2020). Buddhist temples have also been identified as an important source of mental health support for older adults, particularly where formal mental health services remain limited (Nguyen, 2016). Together, this body of work underscores the value of combining family support with broader social policy to improve the mental health of older adults in Vietnam.

Perceived social support—from friends, family, and community—has similarly been associated with better mental health outcomes among older adults, including lower depression and stress and improved quality of life (Taylor, 2011). Older adults who report greater social support tend to show reduced anxiety and greater coping capacity (Cohen & Wills, 1985), and emotional support from family has been associated with more stable mental states and lower risk of anxiety disorders (Uchino, 2006). Positive social relationships have also been associated with a reduced impact of stress on mental health, with older adults who receive emotional support from friends and family reporting lower stress and fewer depressive symptoms (Thoits, 2011).

With respect to cognitive health, social support has also been examined in relation to cognitive decline. Research by Fratiglioni et al. (2000) showed that older people with a large social network and maintaining positive social interactions have a lower risk of developing dementia.

Taken together, this literature suggests that family connection and perceived social support may be associated with better mental health among older adults, and that strengthening social relationships may represent a valuable component of strategies to support healthy aging.

Material and methods

General objectives

O1. To describe the characteristics of social support and the mental health status of older adults residing in institutional care facilities.

O2. To examine associations between social support—specifically frequency of family contact and perceived social support—and mental health outcomes (stress, anxiety, depression, and cognitive function) among institutionalized older adults.

Research questions

1. How are frequency of family contact and perceived social support associated with mental health outcomes (stress, anxiety, depression, and cognitive function) among older adults in residential care facilities?
2. Among the dimensions of social support examined, which shows a stronger association with mental health outcomes, and which serves as a complementary factor?

Sample

Participants were recruited from Dien Hong Nursing Home, Hanoi, Vietnam, using a purposive, non-probability sampling method. Inclusion criteria were: (1) age over 60 years; (2) residence at the nursing home for at least 3 months; and (3) ability to understand the study procedures and communicate with the researcher. Participants were excluded if they had a documented diagnosis of dementia or another major neurocognitive disorder, had severe hearing or visual impairment that prevented effective communication, or had resided in the nursing home for less than three months.

The MMSE was used in this study as a measure of cognitive function rather than as a screening or exclusion criterion. Accordingly, participants with lower MMSE scores, including those in the mild-to-moderate range, were retained in the sample provided they met the inclusion criteria above.

Measures

Cognitive function. The Mini-Mental State Examination (MMSE), originally developed by Folstein et al. (1975), was used to assess cognitive functioning. The MMSE evaluates orientation, memory, attention, language, and visuospatial abilities, with total scores ranging from 0 to 30. Higher scores indicate better cognitive functioning, whereas lower scores indicate greater cognitive impairment (Folstein et al., 1975). The MMSE was used as an indicator of cognitive functioning rather than as a measure of psychological mental health. Accordingly, it was analyzed separately from the measures of stress, anxiety, and depression.

Stress, anxiety, and depression were assessed using the 21-item Depression Anxiety Stress Scale (DASS-21), which comprises three subscales measuring depression, anxiety, and stress. Participants rated the extent to which they experienced each item over the past week on a 4-point Likert scale ranging from 0 (“did not apply to me at all”) to 3 (“applied to me very much or most of the time”), with higher scores indicating greater symptom severity. Subscale scores were calculated using the normal scoring procedure, with items distributed as follows: stress (items 1, 6, 8, 11, 12, 14, 18), anxiety (items 2, 4, 7, 9, 15, 19, 20), and depression (items 3, 5, 10, 13, 16, 17, 21).

Perceived social support. Perceived social support was measured using the 8-item Perceived Social Support Scale (PSS-8), adapted from the Vietnamese-validated version by Dao-Tran et al. (2017). The scale assesses perceived support from family, friends, community, and significant others on a 4-point Likert scale, with total scores ranging from 8 to 32; higher scores indicate greater perceived social support. Internal consistency in the present sample was excellent (α = .906).

The DASS-21 was administered using the Vietnamese-validated version developed by Tran et al. (2013) and further validated by Le et al. (2017). In the current sample (N = 196), internal consistency of the full DASS-21 was acceptable (α = .744). Subscale reliabilities were α = .539 (Depression), α = .398 (Anxiety), and α = .391 (Stress). These comparatively low subscale alphas are consistent with prior Vietnamese validation studies, in which the stress subscale in particular has shown lower reliability (Le et al., 2017; Tran et al., 2013), and may reflect the restricted score variance characteristic of a non-clinical institutionalized sample with generally low levels of psychological distress. Given these subscale reliabilities, findings involving the individual DASS-21 subscales should be interpreted with appropriate caution.

The MMSE was administered using the Vietnamese version adapted by Long et al. (2022), which has established validity for older adults in Vietnam. Internal consistency in this sample was acceptable (α = .728). Because the MMSE is a formative rather than a reflective measure—each domain assesses a distinct cognitive ability—Cronbach’s alpha is reported for completeness but should be interpreted with caution (Truong et al., 2024).

Procedure

Prior to data collection, eligible participants were identified from the nursing home resident registry based on the inclusion and exclusion criteria described above. Nursing home staff facilitated access to the registry and initial contact with eligible residents; however, determination of eligibility was made by the researcher, and the decision to participate was made independently by each resident. Data were collected through face-to-face administration of structured questionnaires by the researcher, over approximately 30-45 minutes per participant. When needed, the researcher clarified item wording to support comprehension, without influencing participants’ responses. All information was anonymized and kept confidential throughout the study; procedures related to ethical approval and informed consent are detailed in the Ethics section below.

Separate multivariate linear regression models were estimated for each outcome variable (stress, anxiety, depression, and MMSE score), with perceived social support and frequency of family contact entered as independent variables.                 

Results

Mental health status, perceived social support score, and level of contact with family of older adults at Dien Hong Nursing Center

Data on cognitive function and psychological distress were collected using the MMSE and the DASS-21. Scale scores were computed in SPSS 23 for the full sample (N = 196).

Table 1

Descriptive Statistics of Mental Health Variables (N = 196) (to see Table 1, please click here)

Stress scores ranged from 0 to 11 (M = 5.90, SD = 2.74). Anxiety scores ranged from 0 to 9 (M = 3.33, SD = 2.30). Depression scores ranged from 0 to 10 (M = 3.06, SD = 2.76). Cognitive function (MMSE) scores ranged from 13 to 30 (M = 23.32, SD = 4.62), with higher scores indicating better cognitive function. All four variables showed considerable variability across participants, as reflected in their standard deviations.

Table 2

Descriptive Statistics of Perceived Social Support and Family Contact (N = 196) (to see Table 2, please click here)

Perceived social support scores ranged from 19 to 32 (M = 25.02, SD = 4.50, SE = 0.32). Frequency of family contact ranged from 2 to 5 (M = 3.92, SD = 0.88, SE = 0.06). Perceived social support showed greater variability across participants than frequency of family contact.

Correlations among study variables

Table 3

Correlations among Study Variables (N = 196) (to see Table 3, please click here)

Perceived social support was negatively correlated with depression (r = -.71, p < .01), stress (r = -.54, p < .01), and anxiety (r = -.29, p < .01) scores. Stress was positively correlated with depression (r = .68, p < .01) and anxiety (r = .61, p < .01), and anxiety was positively correlated with depression (r = .37, p < .01). Cognitive function (MMSE) scores were negatively correlated with stress (r = -.22, p < .01) and anxiety (r = -.25, p < .01), were not significantly correlated with depression (r = .01, p = .923), and were not significantly correlated with perceived social support (r = .04, p > .05).

Associations between social support, family contact, and mental health outcomes

Table 4

Summary of Multivariate Linear Regression Models (N = 196) (to see Table 4, please click here)

Table 4 presents the results of separate multivariate linear regression models estimated for each mental health outcome, with perceived social support and frequency of family contact as independent variables.

For anxiety (Adjusted R² = .13), perceived social support was a significant negative predictor (β = -.30, p < .001). Relative to the “Rarely” contact group (9.2%, n = 18), “Occasionally” contact was associated with higher anxiety scores (β = .29, p = .006); “Frequently” and “Very frequent” contact were not significant predictors.

For stress (Adjusted R² = .32), perceived social support was a significant negative predictor (β = -.50, p < .001). Relative to “Rarely” contact, “Occasionally” (β = -.28, p = .003), “Frequently” (β = -.31, p = .004), and “Very frequent” (β = -.36, p = .001) contact were each associated with lower stress scores.

For depression (Adjusted R² = .51), perceived social support was a significant negative predictor (β = -.62, p < .001). Relative to “Rarely” contact, only “Very frequent” contact was significantly associated with lower depression scores (β = -.24, p = .008); “Occasionally” and “Frequently” contact were not significant.

For cognitive function (MMSE score; Adjusted R² = .10), perceived social support was not a significant predictor (β = -.17, p = .076). Relative to “Rarely” contact, “Frequently” (β = .37, p = .004) and “Very frequent” (β = .59, p < .001) contact were each associated with higher MMSE scores.

Discussion

The present findings indicate that both perceived social support and frequency of family contact are associated with the psychological well-being of older adults in Vietnamese institutional care. These results are broadly consistent with the buffering hypothesis, which proposes that social resources may act as a protective mechanism against stress, anxiety, and depression in later life (Cohen & Wills, 1985). The regression models accounted for a substantial proportion of variance in psychological distress (Adjusted R² ranging from .13 for anxiety to .51 for depression), suggesting a meaningful association between these psychosocial factors and mental health symptoms.

Descriptively, stress scores were higher on average than anxiety and depression scores, although all three outcomes showed considerable variability across participants. Perceived social support also showed greater variability than frequency of family contact, suggesting that while family contact was relatively consistent across participants, the subjective experience of feeling supported differed more widely.

Perceived support versus structural contact

An important contribution of this study is the distinction between functional support (perceived social support) and structural support (frequency of family contact). Perceived social support showed a stronger association with mental health outcomes than family contact frequency, particularly for depression (β = -.62, p < .001). This pattern is broadly consistent with Cognitive Appraisal Theory, which proposes that the subjective belief in the availability of support may be more psychologically relevant than the objective frequency of social interactions (Lynch et al., 2000). Comparable patterns have been reported among institutionalized older adults in India and Malaysia, where the perceived adequacy of social ties appeared more closely associated with well-being than visit frequency alone (Rakesh et al., 2024; Tengku Mohd et al., 2019). This may help explain why residents with similar levels of family contact reported differing levels of perceived social support in the present sample: the quality and perceived availability of support may be more closely associated with psychological well-being than contact frequency alone.

One notable finding was that “Occasionally” contact was associated with significantly higher anxiety than “Rarely” contact (β = .29, p = .006). One possible interpretation is that intermittent family visits may be linked to heightened anticipation or unmet expectations, whereas less frequent contact may reflect a degree of psychological adjustment to lower family involvement over time; however, this interpretation is speculative and warrants further investigation, particularly given the considerable variability in anxiety scores across participants. This finding should be examined in future studies with larger and more diverse samples.

Cultural Nuances: Filial Piety in the Vietnamese Context

In the Vietnamese cultural context, where filial piety (Đạo Hiếu) is a central value in the care of older adults, the transition to institutional care may be experienced by some residents as a departure from traditional family caregiving norms. The pattern observed here—in which “Very frequent” family contact was associated with lower depression (β = -.24, p = .008) and lower stress relative to less frequent contact—is consistent with the possibility that frequent intergenerational contact remains an important aspect of older adults’ sense of connection and belonging, in line with regional findings on filial piety in Southeast Asia (Tengku Mohd et al., 2019). The present findings also raise a further possibility: that relationships with staff and peers within the institutional setting may contribute to residents’ broader sense of being supported, potentially complementing family relationships. The greater variability in perceived social support relative to family contact frequency is consistent with this possibility, although it was not directly tested in this study.

Cognitive function

Unlike the models for stress, anxiety, and depression, perceived social support and family contact together accounted for a comparatively smaller proportion of variance in MMSE scores (Adjusted R² = .10), and perceived social support was not a significant predictor of MMSE score. While prior research has documented associations between social support and depressive symptoms among nursing home residents (Rakesh et al., 2024; Tengku Mohd et al., 2019), fewer studies have examined cognitive outcomes within the same multivariate framework alongside psychosocial predictors. This pattern suggests that, in this cross-sectional sample, cognitive function may be less closely associated with current social dynamics than affective outcomes are, and that factors not measured in this study likely account for a substantial portion of the remaining variance in MMSE scores.

Limitations and further directions

Several limitations should be considered when interpreting these findings. First, the cross-sectional design does not permit causal inference; while social support was associated with better mental health outcomes, it is equally plausible that individuals with better mental health are more able to maintain social ties. Second, the use of a non-probability sample from a single institution in Vietnam limits the generalizability of the findings. Third, the comparatively low internal consistency of some DASS-21 subscales warrants caution when interpreting findings related to these individual symptom domains, although the full scale showed acceptable reliability. Finally, as with all self-report measures, the possibility of self-report bias should be considered.

Future longitudinal research is needed to clarify the direction of these associations and to account for potential confounding variables, such as institutional care quality and pre-existing physical health conditions.

Conclusions

This study underscores the role of perceived social support and family connection in safeguarding the mental health of older adults within Vietnamese residential care settings. The findings reveal that while family ties remain a culturally significant asset, the subjective perception of being supported (perceived social support) is more strongly associated with reduced stress, anxiety, and depression than the frequency of contact alone—though frequent family contact remains an independently associated factor, particularly for stress and depression. Notably, the lack of a significant association between these social factors and cognitive impairment suggests that neurological health in this population may be driven by distinct biological or environmental determinants.

The practical implications are twofold. First, nursing home administrators should extend beyond facilitating family visits and prioritize the quality of interpersonal care and peer-support networks within the facility. Second, interventions should be tailored to address the psychological transition of entering institutional care, ensuring that residents feel emotionally “connected” even when physically separated from their traditional family units.

In conclusion, as Vietnam’s long-term care sector continues to evolve, integrating comprehensive psychosocial support programs into nursing home care is consistent with culturally embedded norms and expectations of family support in Vietnamese society. The findings of this study— that PSS is the strongest predictor of depression (β = −.62, p < .001) and stress (β = −.50, p < .001), while frequent family contact provides additional and independent protection, particularly against stress (β = −.36 for very frequent contact, p = .001)—underscore the complementary roles of perceived and structural social support. To serve the dual goals of honoring traditional values and meeting modern mental health standards, future interventions should prioritize both formal PSS enhancement programs and structured family engagement initiatives, especially for residents with infrequent or irregular family contact. Routine mental health screening using validated tools such as the DASS-21, combined with tailored psychosocial programming, may represent a feasible and culturally appropriate strategy for improving psychological well-being in this underserved population. Policymakers in Vietnam may consider establishing minimum standards for psychosocial care in licensed residential care facilities, including structured family engagement protocols and access to social work services.

Competing interests

The author declares no conflict of interest.

Funding

This research was funded by ULSA University of Labour and Social Affairs, Hanoi, under project number [CT2025.03.64].

Ethics Committee Approval

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the University of Labour and Social Affairs, Hanoi (Certificate no. 2892/QD-DHLDXH). Permission to conduct the study was also obtained from the management of Dien Hong Nursing Home.

Consent to participate

All participants were fully informed about the purpose, procedures, voluntary nature of participation, and confidentiality of the study. Written informed consent was obtained from each participant prior to data collection. Participants were informed of their right to refuse to answer any question or withdraw from the study at any time without any consequences. All collected data were anonymized and treated confidentially. Personal identifiers were removed, and data were used exclusively for research purposes.

Publisher’s Note

The views expressed in this article are solely those of the author and do not necessarily reflect the positions of their affiliated organizations, the publisher, the editors, or the reviewers.

Acknowledgements

The author thanks the staff and residents of Dien Hong Nursing Home, Hanoi, for their participation and cooperation. This research was funded by the University of Labour and Social Affairs, Hanoi, under project number CT2025.03.64.

References

1. Albert, I., & Kornadt, A. E. (2022). The Corona pandemic and its implications for the mental health and mental healthcare of older adults. GeroPsych, 35(1), 1–3. https://doi.org/10.1024/1662-9647/a000286
2. Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310
3. Dao-Tran, T. H., Anderson, D., & Seib, C. (2017). The Vietnamese version of the Perceived Stress Scale (PSS-10): Translation equivalence and psychometric properties among older women. BMC Psychiatry, 17(1), 53. https://doi.org/10.1186/s12888-017-1221-6
4. Dijin, L. (2023). Research on the current situation of mental health management of the elderly under the background of population aging. International Journal of Education and Humanities, 6(3), 120–122. https://doi.org/10.54097/ijeh.v6i3.4760
5. Do, T. H. T., Nguyen, D. T. M., & Nguyen, L. T. (2022). Depressive symptoms and their correlates among older people in rural Viet Nam: A study highlighting the role of family factors. Health Services Insights, 15, 11786329221125410. https://doi.org/10.1177/11786329221125410
6. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6
7. Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M., & Winblad, B. (2000). Influence of social network on occurrence of dementia: A community-based longitudinal study. The Lancet, 355(9212), 1315–1319. https://doi.org/10.1016/S0140-6736(00)02113-9
8. Javed, A. (2022). Mental health of older adults: An agenda for action. Consortium Psychiatricum, 3(1), 6–7. https://doi.org/10.17816/cp156
9. Lynch, T. R., Mendelson, T., Robins, C. J., Krishnan, K. R., George, L. K., Johnson, C. S., & Blazer, D. G. (2000). Perceived social support among depressed elderly, middle-aged, and young-adult samples: Cross-sectional and longitudinal analyses. Journal of Affective Disorders, 55(2–3), 159–170. https://doi.org/10.1016/s0165-0327(99)00017-8
10. Minh, N. H., & Huong, P. T. M. (2021). The care of older adults in the Vietnamese family and related issues. In Aging and the Family: Understanding Changes in Structural and Relationship Dynamics (Vol. 17, pp. 39–61). Emerald Publishing Limited. https://doi.org/10.1108/S1530-353520210000017002
11. Le, M. T. H., Tran, T. D., Tran, H. T. M., Fisher, J., & Tran, T. (2017). Reliability, convergent validity and factor structure of the DASS-21 in a sample of Vietnamese adolescents. PLOS ONE, 12(7), e0180557. https://doi.org/10.1371/journal.pone.0180557
12. Nguyen, N. H. (2016). Mental health care for elderly people at formal mental health systems and Buddhist temples in Vietnam. Ageing International, 41(4), 394–413. https://doi.org/10.1007/s12126-016-9263-5
13. Long, C. M., Thanh, H. T. K., & Toan, T. K. (2022). Gia tri cua trac nghiem danh gia trang thai tam than toi thieu (MMSE) trong sang loc sa sut tri tue o nguoi cao tuoi tai cong dong [Value of Mini-Mental State Examination (MMSE) in screening for dementia among community-dwelling older adults]. Tap chi Nghien cuu Y hoc [Journal of Medical Research], 149(1), 229–236. https://doi.org/10.52852/tcncyh.v149i1.525
14. Paiva, T. C., Soares, L., & Faria, A. L. (2023). Depression in elderly people. Encyclopedia, 3(2), 2. https://doi.org/10.3390/encyclopedia3020048
15. Puglia, D. J. (2022). Mental health in older adults. In B. Sheng (Ed.), Geriatric Medicine (pp. 1–18). Springer. https://doi.org/10.1007/978-981-16-1914-4_109-1
16. Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52, 102066. https://doi.org/10.1016/j.ajp.2020.102066
17. Rakesh, G., Thirumoorthy, A., & Sojan, A. (2024). Perceived social support, loneliness, and depression among elderly living in old-age homes. Journal of Family Medicine and Primary Care, 13(3), 799–805. https://doi.org/10.4103/jfmpc.jfmpc_799_23
18. Taylor, S. E. (2011). Social support: A review. In H. S. Friedman (Ed.), The Oxford Handbook of Health Psychology (pp. 189–214). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195342819.013.0009
19. Tengku Mohd, T. A. M., Yunus, R. M., Hairi, F., Hairi, N. N., & Choo, W. Y. (2019). Social support and depression among community dwelling older adults in Asia: A systematic review. BMJ Open, 9(7), e026667. https://doi.org/10.1136/bmjopen-2018-026667
20. Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161. https://doi.org/10.1177/0022146510395592
21. Tran, T. D., Tran, T., & Fisher, J. (2013). Validation of the Depression Anxiety Stress Scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women. BMC Psychiatry, 13, 24. https://doi.org/10.1186/1471-244X-13-24
22. Truong, T. N., Nguyen, T. T., Nguyen, N. H., Tran, T. T., Vu, T. T., & Nguyen, H. T. (2024). Examining the validity of the Mini-Mental State Examination (MMSE) and its domains using network analysis. Psychogeriatrics, 24(1), 112–121. https://doi.org/10.1111/psyg.13069
23. Uchino, B. N. (2006). Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29(4), 377–387. https://doi.org/10.1007/s10865-006-9056-5