Health status and well‐being of older adults living in the community and in residential care settings: Are differences influenced by age?

Abstract

The objective is to identify the differences and the main factors influencing health status and well‐being variables between institutionalized and non‐institutionalized older adults, as well as the interaction effect of institutionalization and age. Data on a total of 468 older adults from a national survey on non‐institutionalized and from a study on institutionalized older people were analyzed. Socio‐demographic variables and measures on well‐being (Personal Well‐being Index, PWI), health status (EQ‐5D), functional ability (Barthel Index), depression (Hospital Anxiety and Depression Scale‐Depression subscale), loneliness and comorbidity were used. Analysis of variance and Kruskal–Wallis tests to examine differences between groups and multiple regression analyses to identify factors associated to health and well-being were performed. Significant differences in health status variables, but not in well‐being were detected between groups. Controlling for age, differences in health status (EQ‐VAS) were found to be not significant in both groups. In the non‐institutionalized group, people aged 78 years or more reported a significantly lower well‐being (PWI) than younger counterparts. Step‐wise multiple regression analysis showed that depression, functional dependence, loneliness and sex were associated with health status; while depression, health status, loneliness and the interaction of age‐institutionalization were related to well‐being. The results suggest that age influences community‐dwelling older adults’ well‐being to a greater extent than it does to institutionalized older people. This finding has implications for resource allocation and interventions addressed to improve health and well‐being in older adults.

Keywords:

• aged
• determinants of health
• subjective well‐being
• institutionalization
• community‐dwelling

Acknowledgments

This research was supported by the Spanish Ministry of Science and Innovation (National R&D&I Plan: ref. SEJ2006‐15122‐C02‐01 and SEJ2006‐15122‐C02‐01). The authors especially thank Salome Martin Garcia and Iluminada Martinez Lopez (EULEN Social Care Services) for contributing to this study with the valuable information of institutionalized older adults. M.A. Prieto‐Flores’ current post is funded by the Juan de la Cierva Postdoctoral Research Program, Spanish Ministry of Science and Innovation. The Spanish Research Group on Quality of Life and Ageing is made up as follows at the: (1) Carlos III Institute of Health by M. Joao Forjaz, Pablo Martinez‐Martin, Maria‐Eugenia Prieto‐Flores, Belen Frades‐Payo, Carmen Rodriguez‐Blazquez, Concepcion Delgado‐Sanz, and Alba Ayala; (2) Spanish Nacional Research Council by Gloria Fernandez‐Mayoralas, Fermina Rojo‐Perez, and Karim Ahmed‐Mohamed; (3) University of Zaragoza by Raul Lardies‐Bosque; and (4) EULEN Social and Health Services by Salome Martin, and Iluminada Martinez. The Carlos III Institute of Health team is a member of the Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas ‐ CIBERNED).