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.