Levels of psychological abuse and their relationship with possible cognitive impairment among rural older adults in China: a cross-sectional study using latent profile analysis

Aims This study aimed to identify different levels of psychological abuse among rural older adults in China using latent profile analysis and to examine the association between these levels and possible cognitive impairment. Methods The study used a convenience sampling method. From July to October 2025, we conducted a cross-sectional study of psychological abuse among rural older adults in Puyang City, Henan Province, China. Participants completed a demographic questionnaire, the Elder Psychological Abuse Scale in Domestic Setting, the Chinese version of Ascertain Dementia (AD8), and the Lubben Social Network Scale-6 (LSNS-6). Latent profile analysis (LPA) was used to identify groups of rural older adults based on dimensions of psychological abuse. Multinomial logistic regression analysis was conducted to explore the association between possible cognitive impairment and psychological abuse group membership. Results A total of 502 valid questionnaires were included in the final analysis. Among rural older adults, 88.8% ( n = 446) were identified as having possible cognitive impairment, and 11.2% ( n = 56) were not. Three different levels of psychological abuse were identified among rural older adults: low level of psychological abuse group (Group 1, n = 207, 41.2%), moderate level of psychological abuse group (Group 2, n = 261, 52.0%), and high level of psychological abuse group (Group 3, n = 34, 6.8%). Multinomial regression analyses showed that possible cognitive impairment was a significant factor associated with psychological abuse group membership ( p < 0.05). Conclusion Three different levels of psychological abuse were identified among rural older adults, showing significant differences in possible cognitive impairment across group membership. Therefore, future intervention programs should prioritize rural older adults, particularly those with possible cognitive impairment, to implement effective strategies for reducing psychological abuse.