Table 3 The domains/characteristics of tools

MoCA

Evaluate overall cognitive function; Developed by Nasreddine et al., it is an internationally recognized MCI screening tool that evaluates eight cognitive domains: attention, visual space and executive function, memory, language, abstract thinking, computation, and directional ability. It consists of 12 questions with a total score of 30 points. A score of 26 or higher indicates normal cognition, while a score of higher indicates better cognitive function. If the education period is less than 12 years, a score greater than 25 is considered normal, and the lower the score, the more severe the cognitive impairment of the patient; Detect Cronbach's α Coefficient 0.83, specificity 0.87

MMSE

Evaluate overall cognitive function; MMSE has a total score of 30 points, consisting of 30 items covering 7 cognitive domains: orientation, memory, attention and computation, language, and visual-spatial structure. This scale is used to evaluate the overall cognitive function of the study subjects and can effectively distinguish between normal individuals and elderly individuals with dementia. This study adopts the revised version by Wang Zhengyu et al. and sets an outlier threshold based on educational level. When the illiterate group scores ≤ 17 points, the primary school group scores ≤ 20 points, and the middle school and above group scores ≤ 24 points, it is considered abnormal

AVLT

This study adopts the Chinese version of AVLT developed by Guo Qihao and others from Shanghai Huashan Hospital, which has good reliability and validity and has important application value for clinical guidance and scientific research. The operation of this scale mainly involves the researcher reading 12 words: coat, driver, pants, crabapple, carpenter, lily, headscarf, wintersweet, soldier, magnolia, lawyer, and glove. After each reading, the patient is asked to repeat as many words as possible and record them. The number of repeated words in the 3 times is added as the instant memory quantity (i.e. N1 + N2 + N3); After 5 min, ask the patient to recall 12 words and say if they still remember them. The researcher recorded the number as short-term memory (N4); After 20 min, ask the patient about the number of words they remember as long-delayed memory (N5); Finally, a re-recognition test was conducted, with a total of 24 words and 50% of the vocabulary with 12 interfering items. The patient responded with "said" or "not said", and the researcher determined that each correct answer scored one point

SDMT

SDMT is commonly used for testing attention, learning, and conversion abilities. This test is a numerical symbol subtest in the revised Wechsler Adult Intelligence Revised in China (WAIS-RC), which reflects the information processing speed of the subject. During the testing process, participants were provided with a piece of paper with a template containing 9 digits, each with its corresponding symbol. The test requires patients to fill in as many and as quickly as possible the corresponding numbers of the symbols in the spaces below the numbers. The subjects should fill in as many and correct numbers as possible within 90 s. When it's time to calculate the correct number, the higher the score, the better the tester's attention and conversion ability

SAS

GDS is the SAS Self-Rating Anxiety Scale that was designed and developed by Zung in 1971 in the United States to measure the degree of individual anxiety symptoms. The scale has a total of 20 items, of which 5, 9, 13, 17, and 19 are scored in reverse. The scale adopts a scale of 1–4 (scoring method: 1 point for no or very little time; 2 points for a small portion of time; 3 points for a considerable amount of time; 4 points for the vast majority or all of time). Individuals fill out the scale based on their own situation in the most recent week, multiply the total score by 1.25, take an integer as the standard score, and use it as a statistical indicator. The higher the standard score, the more severe the anxiety level of the individual. The scale score can only serve as a reference indicator for evaluating anxiety and cannot be used for diagnosis

GDS

GDS is used to screen for depressive symptoms in the elderly population and is one of the most commonly used scales in China to evaluate the depressive status of the elderly. This study used GDS-15, which contains 15 items and can be used for rapid screening of elderly people with depressive symptoms. It is an internationally commonly used scale. Define a score of 0–4 as no depressive symptoms, 5–8 as mild depressive symptoms, 9–11 as moderate depressive symptoms, and 12–15 as severe depressive symptoms

MUNSH

This scale is used to measure the current level of happiness experienced by participants; Contains 24 items: each item is a description of emotions or experiences, requiring a response of "yes", "no", or "not knowing" based on recent life experiences; Regardless of whether the item is positive or negative, the answer "yes" is recorded as 2 points, "no" is recorded as 0 points, and "don't know" is recorded as 1 point. All items have a score range of 0 to 24 points, and the total subjective well-being score is equal to the positive item score minus the negative item score, with a value of -24 points to + 24 points. To avoid negative points, the total score is added to a constant of 24 points, and the final score range is 0 to 48 points

QoL-AD

This scale can be used to measure the quality of life of patients with cognitive impairment, reflecting the physiological, psychological, and social relationships, and some complex life abilities of the elderly. The scale consists of 4 dimensions and 13 subordinate items. The 4 dimensions are physical health and behavioral compliance, mental state, living environment and social relationships, and life satisfaction. Each item is scored into four levels, namely poor, average, good, and very good. The score is positively correlated with quality of life, with higher scores indicating higher quality of life. The different criteria are as follows: a QOL-AD score ≤ 26 points indicates a lower quality of life, a QoL-AD score of 27–38 points indicates a moderate quality of life, and a QoL-AD score ≥ 39 points indicates a higher quality of life. The scale Cronbach's α coefficient is 0.66; The intra-group correlation coefficient of the total score is 0.84

GSES

The Chinese version of the General Self-Efficacy Scale was first used in 1995, and some studies have also used GSES to measure self-efficacy in individuals with mild cognitive impairment. The scale consists of 10 items, using the Likert 4-level scoring method. The lowest score is 10 points, and the highest score is 40 points. The higher the score, the better the self-efficacy, that is, the stronger the confidence in dealing with things. The scale has good reliability and validity, Cronbach's α The coefficient ranges from 0.76 to 0.90

SES

This scale was developed by American psychologist Rosenberg in 1965 and has good reliability and validity. This study used the Chinese version of the self-esteem scale revised by Ji Yifu et al., consisting of 10 items, to measure the overall self-esteem level of a single dimension through self-evaluation. Using a four-level scoring system of 1 to 4 points, representing very non-compliant, non compliant, compliant, and very compliant. 1. 2, 4, 6, and 7 are forward counting items, while 3, 5, 8, 9, and 10 are reverse counting items. The total score range is 10 to 40 points, and the higher the total score, the higher the level of self-esteem

HLS

The scale is based on Nutbeam's hierarchical model of health literacy as the theoretical framework to establish an item pool that includes three dimensions: interactive health literacy, critical health literacy, and functional health literacy. There are a total of 19 entries. The content validity index of the total scale is 0.972, and the content validity of each item is 0.83–1.00. Cronbach's α The coefficient is 0.945, with Cronbach's for each dimension α The coefficients are 0 894, 0.909, 0.877. The scale adopts the Likert 5-level scoring method, with scores ranging from "cannot" to "completely possible" ranging from 1–5 points. The higher the total score, the better the level of health literacy

DSCS

Assess the self-management ability of diabetes patients; This scale was developed in 1992 by Hurley and Shea and was simplified into Chinese by domestic scholars Wang Jingxuan et al. Cronbach's α coefficient is 0.92. The scale consists of six dimensions: dietary management, blood glucose monitoring, foot care, exercise management, medication management, prevention, and management of high and low blood sugar. There are a total of 26 items, with a Likert score of 5 points. A score of 1–5 points corresponds to a total score of 26–130. This scale has good reliability and validity when used in both Taiwan and mainland China