Statistical Analysis Methods Research Articles

Tailored guidance to apply the Estimand framework to Trials within Cohorts (TwiCs) studies

Objective: The estimand framework offers a structured approach to define the treatment effect to be estimated in a clinical study. Defining the estimand upfront helps formulating the research question and informs study design, data collection and statistical analysis methods. Since the Trials within Cohorts (TwiCs) design has unique characteristics, the objective of this study is to describe considerations and provide guidance for formulating estimands for TwiCs studies.Methods: The key attributes of an estimand are the target population, treatments that are compared, the endpoint, intercurrent events and their handling, and the population-level summary measure. The estimand framework was applied retrospectively to two TwiCs studies: the SPONGE and UMBRELLA Fit trial. The aim is to demonstrate how the estimand framework can be implemented in TwiCs studies, thereby focusing on considerations relevant for defining the estimand. Three estimands were defined for both studies. For the SPONGE trial, estimators were derived.Results: Intercurrent events considered to occur exclusively or more frequently in TwiCs studies compared to conventional randomized trials included intervention refusal after randomization, misalignment of timing of routine cohort measurements and the intervention period, and participants in the control arm initiating treatments similar to the studied intervention. Considerations for handling refusal after randomization related to decisions on whether the target population should include all eligible participants or the subpopulation that would accept (or undergo) the intervention when offered. Considerations for handling treatment initiation in the control arm and misalignments of timing related to decisions on whether such events should be considered part of treatment policy or whether interest is in a hypothetical scenario where such events do not occur.Conclusion: The TwiCs study design has unique features that pose specific considerations when formulating an estimand. The examples in this study can provide guidance in the definition of estimands in future TwiCs studies.

P019 HYPERTENSION PREVALENCE, HEALTH POLICY, AND GUIDELINES MAPPING: A COMPARATIVE ANALYTIC STUDY ACROSS NINE AFRICAN COUNTRIES 2024

Background: Hypertension, a global burden, increases mortality from cardiovascular and kidney diseases. Worldwide, in 2019, an estimated 1.3 billion adults developed hypertension. In Africa, the cumulative estimated prevalence of hypertension is ∼30.8%. Main Objective: To perform a comparative analysis between African countries focusing on hypertension prevalence, health policy, and guidelines mapping. Methods: A descriptive comparative analytic study compared hypertension data from nine African countries: Eswatini, Ethiopia, Ghana, Kenya, Malawi, Nigeria, Somalia, South Sudan, and Sudan, in 2024. Data included hypertension prevalence, health policy, guidelines’ mapping, and hypertension management responses. Mixed statistical methods of content analysis, percentages, means, and Spearman's correlations were used. Results: Hypertension prevalence varied from 27% in Ethiopia to 43% in Eswatini. Females consistently had higher prevalence than males, 30% in Ethiopia to 47% in Eswatini, suggesting gender-specific risk factors or disparities in healthcare access/utilization. Sudan had the second-highest prevalence 44%. Eswatini implemented strong blood pressure control measures, unlike Sudan. High prevalence was also found in countries with strong policies (Eswatini, Kenya, Nigeria, South Sudan), suggesting urgent improved healthcare delivery, policy enforcement, and addressing other risk factors. Ghana and Somalia had lower hypertension prevalence, though fewer policies. Spearman's test showed strong negative correlations between national responses and hypertension prevalence. Salt Intake Surveys had the strongest negative correlation (-0.707) with hypertension prevalence, highlighting countries like Ethiopia and Malawi with salt intake surveys and lower prevalence, reinforcing dietary factors’ effectiveness in managing hypertension. Kenya, Nigeria, and Ethiopia leverage trained non-physician health workers in hypertension management, thereby, improving treatment access and adherence. Treatment guidelines were moderately negatively correlated (-0.335) with hypertension prevalence. The mere presence of guidelines is insufficient, signifying their implementation and enhancement with targeted interventions Conclusions: These findings highlighted the multifaceted nature of hypertension in African countries which requires comprehensive approaches encompassing considerations of gender, socioeconomic factors, lifestyle, salt reduction, policy implementation, healthcare access, and a unified African hypertension guideline.

Robust discriminant analysis

AbstractDiscriminant analysis (DA) is one of the most popular methods for classification due to its conceptual simplicity, low computational cost, and often solid performance. In its standard form, DA uses the arithmetic mean and sample covariance matrix to estimate the center and scatter of each class. We discuss and illustrate how this makes standard DA very sensitive to suspicious data points, such as outliers and mislabeled cases. We then present an overview of techniques for robust DA, which are more reliable in the presence of deviating cases. In particular, we review DA based on robust estimates of location and scatter, along with graphical diagnostic tools for visualizing the results of DA.This article is categorized under: Statistical and Graphical Methods of Data Analysis > Robust Methods Statistical Learning and Exploratory Methods of the Data Sciences > Clustering and Classification

Mapping local climate zones and its applications at the global scale: A systematic review of the last decade of progress and trend

The concept of local climate zone (LCZ) was proposed in 2012 to meet the needs of refinement and standardization of urban climate research. As an important contribution of the World Urban Database and Access Portal Tool (WUDAPT), which is an initiative to collect and share urban data globally to facilitate urban-focused climate researches, LCZ research has shown a booming trend in the past decade. As of the end of October 2023, more than 400 related papers, which involve about 250 cities in the world, have been published. At this juncture (decadal anniversary of the WUDAPT), a review from a global perspective and outlooks of the LCZ framework, from mapping to application and its coordinated development with WUDAPT, are needed to support the popularity and further progress of LCZ and WUDAPT. In this review, statistical and metadata analysis methods were used to summarize and analyze a sample of LCZ-related papers published since 2012, focusing on two aspects: mapping and application. The mapping methods were divided into three categories, namely, remote sensing-based, geographic information system-based, and hybrid methods. The application topics were grouped into two categories, namely, WUDAPT initiative and novel WUDAPT application. Two relevant themes originated from the above summary were further discussed, and then the future was forecasted on the basis of current research limitations. From this review, researchers can benefit from the recent progress in mapping and application of the LCZ system and future research directions, thereby further promoting the development in this field.

Research on barriers in developing intelligent transport systems in Ho Chi Minh City

and enhance the efficiency of the transportation network in large cities. The process of applying ITS in Ho Chi Minh City still faces many difficulties, limitations, slow implementation, and lack of synchronization. This study focuses on analyzing barriers affecting the development of ITS and proposes specific solutions to address those barriers. The study, through consulting stakeholders, uses statistical analysis methods to evaluate and identify key barriers and their level of impact. The results show an overview of ITS issues and at the same time, identify 11 main barriers affecting ITS development in terms of economy, society, technology, policy, human resources, implementation process, and interoperability. Based on the impact assessment, the study proposes a number of solutions to these problems, thereby contributing to providing a basis for the city to make assessments of barriers and develop appropriate development plans.

ECONOMIC PARTNERSHIP UKRAINE–EU: RETROSPECT AND CHALLENGES OF FURTHER ENHANCED COOPERATION

Ukraine has been a priority partner of the EU since the signing of the Association Agreement in 2014. It was the significant financial and economic support of the EU as a whole and, in particular, of individual EU member states that became a key tool for avoiding catastrophic consequences in the financial and economic system of our country at the beginning of a full-scale war and for the current financing of the state budget deficit. Today, the European Union's support for Ukraine is extremely significant, although it is accompanied by a number of problematic issues that require an in-depth study of certain aspects of economic partnership in terms of finding ways and directions to improve the use of the potential of bilateral economic relations with the European Union as a whole and with individual EU member states.The methodological basis of the study is based on general scientific and special methods of economic theory, in particular, methods of theoretical generalization and comparative analysis for a comprehensive consideration of the research issue, and statistical methods of analysis. In the course of the study, the statistical materials of the European Union and the Ministry of Finance of Ukraine on foreign trade in goods were used.Modern scientific views on the content and prospects of Ukraine's economic partnership with the EU are studied. The key stages of the development of Ukraine's economic partnership with the European Union are summarized and schematized, with details of the areas of sectoral cooperation. The main indicators of trade relations and their role in the economies of the studied countries are analyzed. The key obstacles to further deepening of the economic partnership are substantiated, the elimination of which should be the primary goal of our country on the way to European integration.The obtained results can serve for further study of trade relations and their role in the economies of the studied countries.

Estimand Framework and Statistical Considerations for Integrated Analysis of Clinical Trial Safety Data.

Safety analyses play a pivotal role in drug development, ensuring the protection of patients while advancing innovative pharmaceuticals to market. A single study generally does not have sufficient sample size to evaluate all important safety events with reasonable precision and may not cover the full target population for the investigational treatment. Integrated analyses (pooled or meta-analysis) over several studies may be helpful in that regard. But without a structured conscious workflow accompanied with appropriate statistical methods for the integrated analysis, this can easily take a route compromising the interpretation. In this article we apply the ICH estimand framework to clinical trial integration and summarize respective critical statistical assumptions to ensure the integrated analyses are interpretable. The estimand framework is valuable for developing principles for a deeper understanding of the critical statistical aspects of planning an integrated safety analysis. Our principles address the clinical question of interest, estimand and estimation. Special focus was given to the criteria for inclusion and exclusion of the component studies in the integrated analysis, and to integration of estimates pertaining to signal detection. Performing an integrated analysis and its preparatory steps calls for a good understanding of the clinical question of interest and its estimand, care and sound practice, to enable interpretation and avoid introducing unnecessary bias. It is valuable to use the estimand framework not only for efficacy evaluations, but also for safety evaluations in clinical trials and for integrated safety analyses.

КАЙРА ИШТЕТҮҮ ИШКАНАЛАРЫНЫН КАРЖЫЛЫК РЕСУРСТАРЫНЫН КОЛДОНУЛУУСУ

This article provides an overview analysis of scientific-theoretical studies on the financial resources and resource base of enterprises, including processing enterprises, the directions of their operation, research and recommendations on the use of financial resources. Comparative, analytical, statistical materials analysis methods were used in the research. The purpose of the study is to analyze the formation of financial resources of enterprises, the sources and uses of the resource base. The value of financial resources for the enterprise, as well as the choice of sources of their formation, its value when meeting the requirements of the economic entity are important. Therefore, for the development of processing enterprises, it is necessary to optimize the profitability of the enterprise through the formation of the sources of financial resources, the resource base and the economical use of financial resources. As a result, we have shown that in the process of managing financial resources in enterprises, issues about sources of formation and directions of their use are solved.

The effect of rehabilitation measures on the severity of endotoxicosis and its relationship with changes in hemorheology in acute poisoning

Introduction. The use of multidimensional statistical analysis methods (factorial and cluster methods) to study the pathogenesis and sanogenesis of acute poisoning (AP) with psychopharmacological agents (pPPhA), neurotoxicants (pNT) and corrosive substances (pCS) did not allow us to judge the presence of a direct connection between the hemorhealogy system (HR). We received a positive answer to this question earlier with the help of pair correlation analysis (PCA). New data on the sanogenetic effect of the applied methods of rehabilitation treatment in terms of changes in the indicators of HR and endotoxicosis (ET) and the relationship between them are also interesting. The purpose of the work is to assess the initial state of the indicators of HR and ET and the effect on them of a combination of medicinal and non–medicinal products used as part of rehabilitation measures for AP. Material and methods. Paired correlation analysis of the block structure of the obtained correlation matrices was applied to 52 patients with severe pPPhA, pNT and pCS. This analysis established the relationship between two indicators – both before the start of rehabilitation measures (the use of ethylmethylhydroxypyridine succinate, laser hemotherapy, hyperbaric oxygenation and mesodiencephalic modulation in accordance with the type of AP), and after their completion, before the discharge of patients from the hospital. Results. Statistically significant correlations were established between the indicators of HR and ET both before the start of treatment (0.44–0.94, without sign) and after its completion (0.49–0.99, without sign), which allowed us to confirm at a higher level a direct link between the development of HR and ET disorders, as well as to draw a conclusion about the sanogenetic effect of rehabilitation treatment. Limitations. The study has no limitations for further use of this methodological approach. Conclusion. The obtained data can serve as a justification for the introduction into practice of the proposed methods of mathematical analysis of the results of treatment measures.

PENGARUH INTELLECTUAL CAPITAL, INVESTMENT OPPORTUNITY SET, DAN KEBIJAKAN DIVIDEN TERHADAP NILAI PERUSAHAAN

The purpose of this study is to ascertain intellectual capital, investment opportunity set, also dividend policy on firm value in food and beverage (F&B) sub-sector manufacturing companies registered on the Indonesia Stock Exchange in 2019-2022. The object of this study is manufacturing companies in the F&B sub-sector registered on the Indonesia Stock Exchange in 2019-2022. The sample untilized in this purchase was 18 companies with a research period of 4 years with 72 data processed using purposive sampling techniques. This study employs descriptive statistical analysis methods, also panel data regression analysis. From the outcomes of this study, it was gained that these three variables have a joint impact on the company's value. Meanwhile, intellectual capita, also dividend policies have a negative impact on each. Meanwhile, the investment opportunity set has a positive impact on the company's value

Weight Management Package Based on Knowledge, Attitude, Behavior, and Barriers of Obese Youth in China

This study explored the knowledge, attitudes, behaviors and barriers of obese adolescents in Erqi District, Zhengzhou City, China, in terms of weight loss management. The study adopted a cross-sectional design, collected data through a questionnaire survey, and used statistical analysis methods to explore the relationship between these factors and their association with socio-demographic characteristics. The study found that participants generally had misconceptions about health knowledge, had a negative attitude towards weight, rarely adopted weight-loss behaviors, and faced some barriers to health management. The study revealed a negative correlation between health knowledge and attitudes, a finding that challenges traditional ideas and suggests that simply increasing health knowledge may not be sufficient to change attitudes and behaviors. In addition, the study found that economic factors had a small effect on health-related dimensions, while BMI had a significant effect on knowledge and behavior dimensions. These findings highlight the need to consider the interaction of multiple factors when designing interventions for adolescent obesity, and to fully consider the local socio-cultural context. The results of the study provide a new perspective on understanding the problem of adolescent obesity in China, and also raise questions about current health education and intervention strategies. Future research can further explore the underlying reasons behind these findings, providing a scientific basis for the development of more effective strategies for the prevention and management of adolescent obesity.

Simulation of predicting atrial fibrosis in patients with paroxysmal atrial fibrillation during sinus node recovery time in optical imaging

Paroxysmal atrial fibrillation is a common arrhythmia, and its development process and prediction of the degree of atrial fibrosis are of great significance for treatment and management. Optical imaging technology provides a new means for non-invasive observation of atrial electrical activity. The aim of this study is to investigate the predictive effect of sinus node recovery time on the degree of atrial fibrosis in patients with paroxysmal atrial fibrillation, and to provide a basis for the application of optical imaging technology in the study of atrial fibrosis. The study collected clinical and optical imaging data from a group of patients with paroxysmal atrial fibrillation, and used statistical analysis methods to investigate the relationship between sinus node recovery time and the degree of atrial fibrosis. The research results indicate that there is a significant correlation between the recovery time of the sinus node and the degree of atrial fibrosis, that is, there is a positive correlation between the prolonged recovery time of the sinus node and the aggravation of atrial fibrosis. SNRT can serve as an effective indicator for evaluating atrial matrix and can be applied to predict recurrence after catheter ablation of paroxysmal atrial fibrillation. Shortening SNRT through catheter ablation can become an important predictor of effective catheter ablation.

From sutureless to standard: a comprehensive analysis of conversion rates in laparoscopic partial nephrectomy

ObjectiveTo assess the rate at which sutureless partial nephrectomy (SLPN) transitions to standard partial nephrectomy (SPN), focusing on preoperative factors that might prompt such conversions.Patients and methodsIn this retrospective study, we analyzed the efficacy of SLPN performed on adults at our institution from 2016 to 2023. The subjects were patients diagnosed with localized solid renal tumors. The primary technique employed was resection with scissors and argon beam coagulation for hemostasis, with suturing techniques used only when necessary. Predictive factors necessitating conversion to SPN were identified, and the associations among multiple variables were explored using various statistical analysis methods, including logistic regression, to identify key preoperative predictive factors.ResultsOur institution performed 353 SLPN, with 21 cases (5.9%) necessitating conversion to SPN. The conversion rates for the Laparoscopic Partial Nephrectomy (LPN) subgroup and the Robotic-assist Partial Nephrectomy (RPN) subgroup were 7.9% (17/215) and 2.9% (4/138), respectively, nearing statistical significance (P = .066). Significant differences were observed between the conversion group and the no conversion group in terms of preoperative estimated Glomerular Filtration Rate (eGFR), age at surgery, tumor size, and exophytic/endophytic characteristics. Multivariate analysis identified age at surgery, preoperative eGFR, radiological tumor size, and tumor exophytic/endophytic nature as significant predictors for conversion to SPN.ConclusionThis investigation highlights the efficacy and feasibility of SLPN while identifying critical factors influencing the necessity for conversion to SPN. The identified predictors, including younger surgical age, superior preoperative eGFR, and specific tumor characteristics, provide valuable insights for refining surgical strategies.

Relationships Between Service Quality, Customer Loyalty and Customer Repurchase Intention: The Example of Health and Fitness Clubs

This study was conducted with the aim of testing the relationships between service quality perceptions, customer loyalty levels, and customer repurchase intentions of customers in health and fitness clubs. The sample group for the study comprised 476 individuals (233 female, 243 male) exercising in health and fitness clubs. Participants answered the Turkish version of the “Service Quality Assessment Scale (T-SQAS)”, the Turkish version of the “Loyalty Scale in Sport Services (T-LSSS)” and the Turkish version of the “Repurchase Intention Scale (T-RIS).” For the analysis, t-test, MANOVA, ANOVA, and Pearson correlation statistical methods were used. The most substantial gap between participant expectations and perception scores concerning service quality was observed in the “program” subscale, while conversely, the “locker room” subscale had the smallest difference. The means subscale scores for the “(T-LSSS)” of female participants were identified as being higher than those of male participants. There was a positive relationship between service quality, customer loyalty, and repurchase intention. Finally, it was evident that members were dissatisfied with the services offered, indicating an inconsistency between their expectations and the actual service delivery. Managers of health and fitness clubs should make the necessary effort to increase the service quality of their clubs to the highest level. Positive effects of service quality on the formation of repurchase intention, the first stage of creating loyal customers, will increase the competitive power of health and fitness clubs in the market.

Effects of different parenting styles on the physical health of Chinese university students.

Annual declines in university students' physical health have an impact on social stability and the nation's long-term growth. Parenting style, which is crucial to a child's growth and development, may have a big influence on physical health. This study delves into the effects of different parenting styles on the physical fitness of Chinese college students under gender differences. Through random allocation and stratified sampling methods, this study comprehensively investigated 3,151 undergraduate students (male = 1,365; female = 1786) with an average age of 18.44 years (SD = 1.46), from a university in Jiangsu Province, China. Parenting styles of college students were evaluated by the Parental Bonding Instrument (PBI). Physical fitness tests were based on the Chinese National Student Physical Fitness Standards including body mass index, lung capacity, standing-long-jump, bent-leg-sit-up, seated forward bend, pull-ups, 50 m sprint, and 800/1,000 m run. Further investigations focused on the relationship between parenting styles and physical health by statistical analysis methods such as Pearson correlation and multiple linear regression. Significant differences were identified in gender, family members, and academic majors in most of the correlation indicators between different parenting styles and physical health among college students. Further analysis showed that the parenting styles of democratic and authoritative mothers and democratic fathers were more conducive to the promotion of physical health among female university students. The combination of a democratic fathering style and a permissive mothering style is considered an ideal parenting model for male students. This study confirmed that different parenting styles have a significant impact on the physical health of college students. Positive parenting styles may improve physical health, while negative ones are likely to have adverse effects, especially among female students. It is also important to notice differentiated parenting styles with respect to male and female university students. Therefore, more attention should be raised on parenting styles to enhance physical health of the student population.

Constitutional and legal responsibility of state bodies and senior officials

Kyrgyzstan, with increased political activity and dynamic changes in the governance system, faces problems with the constitutional and legal responsibility of state bodies and their officials, which require the development of effective forms of governance for sustainable strategic development to address them. Therefore, the study aimed to identify problematic aspects of constitutional and legal responsibility in Kyrgyzstan. Statistical analysis, formal logical and comparative methods, and legal and comparative methods were used in the study. The main problems in the system of constitutional and legal liability in Kyrgyzstan were identified, which include insufficient clarity and application of regulations, incomplete implementation of mechanisms for supervision and control over the activities of state bodies and their officials, and limited access of citizens to judicial protection in cases of violation of their constitutional rights. In addition, the study identified problems in the court practice of considering cases of constitutional and legal liability, including delays in the process of consideration and insufficient effectiveness of the measures taken. Based on these findings, specific recommendations were developed containing proposals for improving the legislation, namely, defining the mechanisms of constitutional and legal liability and eliminating contradictions in regulations, strengthening verification mechanisms and mandatory introduction of a reporting system, expanding the possibility of going to court, including reducing barriers to access to legal aid. Thus, the practical significance of this study is that its findings provide a basis for the development of specific measures and reforms aimed at improving the system of constitutional and legal liability in Kyrgyzstan and ensuring the protection of the constitutional rights of citizens

THE ROLE OF LINGUISTIC BACKGROUND IN SHAPING STUDENTS’ READING PROFICIENCY IN VIRTUAL SETTINGS: A CORRELATIONAL STUDY

This research draws from the linguistic relativity hypothesis and sociocultural literacy perspectives to investigate how students’ linguistic backgrounds influence their digital reading practices in English as a Foreign Language (EFL) settings. Specifically, it examines the impact of Algerian Arabic and Berber languages on digital literacy habits among university students. Utilizing a sociocultural approach that views reading as a social activity, a mixed-methods approach combining qualitative and quantitative analyses was employed to ensure the credibility of the findings. The study surveyed students from two different Algerian universities situated in cities where the inhabitants primarily speak different native languages, namely Kabyle and Arabic, respectively. The data were collected through a questionnaire and analysed using both statistical and content analysis methods. Results reveal contrasting reading practices between Arabic and Berber speakers, with Arabic speakers emphasizing cognitive benefits of reading, while Berber speakers view it as a cultural tradition, particularly evident in their digital literacy habits. Digital literacy, for Berber speakers, represents both freedom and a continuation of their oral heritage, shaping their preference for narrative texts. In contrast, Arabic speakers lean towards descriptive texts. In conclusion, this study underscores the influence of linguistic backgrounds on Algerian EFL students’ digital reading behaviours.

Comparative Analyses of Bioequivalence Assessment Methods for In Vitro Permeation Test Data.

For topical, dermatological drug products, an in vitro option to determine bioequivalence (BE) between test and reference products is recommended. In particular, in vitro permeation test (IVPT) data analysis uses a reference-scaled approach for two primary endpoints, cumulative penetration amount (AMT) and maximum flux (Jmax), which takes the within donor variability into consideration. In 2022, the Food and Drug Administration (FDA) published a draft IVPT guidance that includes statistical analysis methods for both balanced and unbalanced cases of IVPT study data. This work presents a comprehensive evaluation of various methodologies used to estimate critical parameters essential in assessing BE. Specifically, we investigate the performance of the FDA draft IVPT guidance approach alongside alternative empirical and model-based methods utilizing mixed-effects models. Our analyses include both simulated scenarios and real-world studies. In simulated scenarios, empirical formulas consistently demonstrate robustness in approximating the true model, particularly in effectively addressing treatment-donor interactions. Conversely, the effectiveness of model-based approaches heavily relies on precise model selection, which significantly influences their results. The research emphasizes the importance of accurate model selection in model-based BE assessment methodologies. It sheds light on the advantages of empirical formulas, highlighting their reliability compared to model-based approaches and offers valuable implications for BE assessments. Our findings underscore the significance of robust methodologies and provide essential insights to advance their understanding and application in the assessment of BE, employed in IVPT data analysis.

A multidimensional financial attractiveness index: Scoring and classification of financial systems

This research paper aims to benchmark the characteristics of financial systems for 102 countries worldwide from the period of 2005 to 2017. The financial systems’ database encompasses four main dimensions, each consisting of several variables for every indicator: (a) financial depth, (b) financial efficiency, (c) financial access, and (d) financial stability. The objective is to closely analyse the different factors that contribute to the attractiveness of financial and economic systems globally. Furthermore, this paper employs a literature review and an empirical modelling and classification of financial systems worldwide to assess their attractiveness. The modelling process utilizes two statistical analysis methods: discriminant analysis (PCA) and neural analysis. By doing so, this research paper aims to identify the most appropriate measures to strengthen these systems and economies. The main conclusion of the research is to establish a ranking of the world’s best countries and also the validation of the hypothesis that macroeconomic conditions are the effective determinants of the classification dimensions of financial systems.

Impact of indoor visual environment on emotional and behavioral symptoms of older people with dementia

Older people with dementia manifest emotional and behavioral symptoms (EBS), such as emotion disorders, environmental adaptation problems, sleep disorders, limited mobility, etc. The indoor visual environment (IVE) in care and attention (C&A) homes may relieve or aggravate those EBS. To improve the IVE in C&A homes and satisfy the special requirements of older people with dementia, this study investigated the impact of the IVE in C&A homes on the EBS in older residents with mild to moderate dementia. The predesigned questionnaire survey was carried out among 100 participants with dementia living in C&A homes, and the interview was conducted with 12 staff members with different positions. An IVE–EBS model was established using various statistical analysis methods. The verified model demonstrated that the space, view out, window, furniture, door, and color significantly influenced the EBS in older people with dementia. Practical recommendations were proposed, including 1) relatively small space and unblocked vision for enhancing their confidence to move around; 2) a quiet view out with greenery, aesthetic scene, and broad perspective; 3) a window-to-floor ratio of the activity room higher than 1:4; 4) wooden furniture for a warm atmosphere; 5) dementia-friendly door wraps to improve the unique features of the doors; 6) a CCT of 2500K–3000K to promote older adults with dementia sleep well in the evening.