title: 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.
authors.affiliation: National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain. crodb@isciii.es
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodriguez-Blazquez
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
authors.forename: Maria-Eugenia
authors.initials: ME
authors.lastname: Prieto-Flores
authors.forename: Fermina
authors.initials: F
authors.lastname: Rojo-Perez
authors.forename: Gloria
authors.initials: G
authors.lastname: Fernandez-Mayoralas
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D003863:Depression / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007326:Institutionalization; D008132:Loneliness; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011788:Quality of Life; D012044:Regression Analysis; D012111:Residence Characteristics; D012737:Sex Factors; D013030:Spain