Objective  To explore and construct a theoretical framework for the downstream effects of social alienation in youny-onset dementia (YOD) patients, based on grounded theory methodology.

Methods  Purpose sampling was employed, and data were collected from January to March 2023 at 3 top tertiary hospitals and 6 community health service centers in Shiyan city, patients with YOD and their caregivers at different levels and stages of cognitive function of the disease courses as study subjects. Data were gathered using semi-structured interviews and analyzed through procedural grounded theory methods using NVIVO 12.0 software for open, axial, and selective coding to test the saturation of the theory.

Results  Cognitive decline process, diminished occupational abilities, emotional isolation and psychological stress, shrinking social activities and interactions, declining life skills and quality, and increased need for medical and social support were the six main dornains of the core category "social alienation downstream effects in YOD patiens" and were categorized as the       central impact, functional decrement, emotional disorder, social disconnection, life adaptation, and support dependence.

Conclusion  This research constructed a six-dimensional theoretical framework for the downstream effects of social alienation in YOD patients. This framework not only provides a theoretical perspective to understand the social alienation experienced by YOD patients and its complex consequences, but also offers a theoretical foundation for healthcare institutions and social organizations to develop targeted nursing strategies and comprehensive care measures for YOD patients.

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