title: Quality of life across three groups of older adults differing in cognitive status and place of residence.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) in older adults is determined by personal conditions, as well as by the social and physical environment. The purpose of the present study was to describe the factors related to health conditions and residential environment that influence HRQOL of older adults.
  
  
  METHODS
  Data from 1815 cases came from three cross-sectional surveys on quality of life in older adults in Spain: non-institutionalized older adults (n = 1106), institutionalized older adults without dementia (n = 234) and institutionalized older adults with dementia (n = 475). Assessment instruments used were: Barthel Index, Short Portable Mental Status Questionnaire, Comorbidity Index, EQ-5D-3L (5 dimensions, EQ-index and EQ-VAS), and information about sociodemographic characteristics and social networks. Partial correlation and multivariate logistic regression analyses were carried out.
  
  
  RESULTS
  In group comparisons, institutionalized older adults showed a higher percentage of problems in the EQ-5D-3L dimensions than the non-institutionalized ones. Also, older adults with dementia presented less pain/discomfort and anxiety/depression than the other groups, but showed more problems in mobility, self-care and usual activities. EQ-Index showed a high association with functional independence, perceived health status and comorbidity. According to the logistic regression models, the Barthel Index was the most common determinant for most of EQ-5D-3L dimensions in all groups.
  
  
  CONCLUSIONS
  Institutionalized older adults with dementia presented lower HRQOL than the other groups. Functional independence, comorbidity and cognitive status were the main HRQOL determinants in all groups. Maintenance and improvement of the functional condition might be translated into a higher HRQOL of older adults.
authors.affiliation: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: León-Salas
authors.forename: Alba
authors.initials: A
authors.lastname: Ayala
authors.forename: Vendula
authors.initials: V
authors.lastname: Blaya-Nováková
authors.forename: Marina
authors.initials: M
authors.lastname: Avila-Villanueva
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodríguez-Blázquez
authors.forename: Fermina
authors.initials: F
authors.lastname: Rojo-Pérez
authors.forename: Gloria
authors.initials: G
authors.lastname: Fernández-Mayoralas
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Martín
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012111:Residence Characteristics; D011795:Surveys and Questionnaires
keywords: EQ-5D-3L; dementia; health-related quality of life; place of residence