Enterprise AI Analysis

Addressing MCI Residential Challenges

China faces rapid population aging, with 264 million people aged 60+ (18.7% of total population). The prevalence of mild cognitive impairment (MCI) among older adults reaches 15.5%, affecting over 38.77 million individuals. MCI presents an intermediate stage between normal aging and dementia, leading to unique residential challenges like spatial disorientation and difficulty operating household devices.

Existing age-friendly housing guidelines primarily target healthy older adults or those with severe disabilities, leaving a research gap for the MCI population. Fuzhou, with a 21.13% aging rate and a substantial stock of 1990s-era housing, exemplifies the need for evidence-based adaptation. This study aims to develop an integrated IPA-regression model to identify priority intervention needs, quantify influence weights of spatial elements on satisfaction, and propose actionable intervention strategies, specifically focusing on the overlooked MCI demographic.

Study Design & Data Collection

A cross-sectional survey was conducted from March to June 2024 in four representative neighborhoods in Fuzhou's Gulou and Taijiang districts. Inclusion criteria required participants to be ≥60 years, have MCI confirmed via MoCA scores (19-25, education-adjusted), demonstrate functional independence (ADL ≤3), and reside in their home for ≥1 year. A total of 315 eligible participants were enrolled through community centers, with demographic distribution checked against Fuzhou statistics for representativeness.

Assessment Instrument & Data Analysis

The "MCI-Friendly Residential Space Assessment Scale" was developed based on literature review, expert consultation, and international standards. This scale covers 7 spaces with 20 assessment items each, measuring importance and satisfaction on 5-point Likert scales. Reliability metrics were strong: Cronbach's α = 0.912, KMO = 0.924, and Bartlett's p < 0.001.

Importance-Performance Analysis (IPA): A four-quadrant matrix plotted mean importance against mean satisfaction, with global means as the origin. Quadrant I (Concentrate Here) indicates high importance/low satisfaction, signaling immediate intervention needs. Priority gaps were quantified as Aj = Ij – Sj.

Multiple Regression: Stepwise regression models were used with overall satisfaction as the dependent variable and 20 item-specific satisfaction scores as predictors (entry α = 0.05, removal α = 0.10). Models were assessed via adjusted R², VIF, and Durbin-Watson statistics.

Cross-Validation: Items in IPA Quadrant I with significant β coefficients in regression were designated as core intervention targets. A compact priority score (CPS = 0.6 z(A) + 0.4 z(|βstd|)) was used for ranking to reconcile statistical significance with perceived salience.

Three-Tiered Intervention Framework

Based on integrated IPA and regression analysis, a three-tiered intervention strategy is proposed to optimize residential spaces for older adults with MCI.

Critical Design Specifications & Implementation Pathway

• Level-Free Design: Bathroom thresholds (Importance 4.78, Satisfaction 2.59, Gap 2.19) are a critical deficiency, with 83% of homes retaining 3-5cm thresholds. Japan's JIS T 0101 mandates <2cm transitions, supporting mandatory retrofitting.
• Golden Storage Zone: Optimal ergonomic zone 80-120cm for kitchen wall cabinets, bedroom drawers, and dining sideboards.
• Illumination Enhancement: Average illuminance (180 lux) falls below recommended ≥400 lux. A three-tiered system is proposed: 400 lux overhead LED (base), 600 lux at work surfaces (task), 20 lux motion-activated pathway lighting (safety).
• Smart Technology Principle: "Low-Complexity Priority" is key, focusing on motion-activated lighting, passive monitors, and one-touch emergency calls over app-dependent systems.

Fuzhou Implementation Pathway proposes a standardized assessment-design-construction-acceptance protocol, tiered subsidies (Grade A: Safety, Grade B: Accessibility, Grade C: Cognitive), pilot programs, and cost optimization through local material substitution.

Summary of Findings & Practical Implications

This integrated IPA-regression model systematically prioritized housing interventions for community-dwelling older adults with MCI in Fuzhou. The two-layer computational pipeline successfully identified key areas for intervention. Practical conclusions include:

• Prioritize safety infrastructure: Slip-resistant flooring, grab bars, level-free transitions are paramount.
• Ensure circulation width and accessible storage to reduce effort and hazards for MCI users.
• Stage smart-home features: Despite high regression coefficients, their IPA salience is low for MCI users, indicating a non-urgent status initially.
• Apply a sequential, three-tier intervention order: Safety → Circulation/Storage → Smart add-ons.

Research Limitations: Geographical constraints (Fuzhou only), cross-sectional design, self-report bias, and exclusion of moderate-severe cognitive impairment limit generalizability. Future research should expand geographical scope, implement longitudinal monitoring, and include objective indicators (fall rates, independence scores).