Factors Associated with Health-Related Quality of Life in Older Persons Residing in Nursing Homes

Anne-Marie Boström; Tommy Cederholm; Gerd Faxén-Irving; Erika Franzén; Helena Grönstedt; Åke Seiger; Sofia Vikström; Anders Wimo

doi:10.2147/JMDH.S381332

Factors Associated with Health-Related Quality of Life in Older Persons Residing in Nursing Homes

J Multidiscip Healthc. 2022 Nov 11:15:2615-2622. doi: 10.2147/JMDH.S381332. eCollection 2022.

Authors

Anne-Marie Boström¹, Tommy Cederholm², Gerd Faxén-Irving³, Erika Franzén⁴, Helena Grönstedt⁵, Åke Seiger³, Sofia Vikström⁶, Anders Wimo⁷

Affiliations

¹ Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm and R&D Unit, Stockholms Sjukhem, Stockholm, Sweden.
² Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm and Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
³ Division of Clinical Geriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
⁴ Division of Physiotherapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Medical Unit Occupational Therapy and Physiotherapy, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm and Stockholms Sjukhem R&D Unit, Stockholm, Sweden.
⁵ Medical Unit Occupational therapy and Physiotherapy, Women´s Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.
⁶ Division of Occupational Therapy, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
⁷ Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.

Abstract

Purpose: Health-related quality of life (HRQoL) is an important patient-related outcome for the assessment of interventions and treatments in older people. Understanding underlying mechanisms for HRQoL is crucial for improving care, rehabilitation and symptom relief. This study examined the associations between HRQoL and frailty, sarcopenia, dependence of ADL, physical function and nutritional status in older nursing home (NH) residents.

Patients and methods: This is a cross-sectional study employing baseline data from the Older Person's Exercise and Nutrition (OPEN) study. Residents ≥75 years and able to stand up from seated position, residing in eight nursing homes in Sweden, were recruited. The EuroQoL 5-dimension Questionnaire (EQ-5D-5L, 0-1) was used to assess HRQoL. For exposure, the FRAIL and SARC-F questionnaires, Bergs Balance Scale, Functional Independence Measure (FIM), and Mini Nutritional Assessment-Short Form (MNA-SF) were used, including chair-stand test, walking speed and some biochemical markers. Descriptive and inferential statistics including linear regression models were applied.

Results: Data from 113 residents (59% women, mean age 85 years) revealed a mean EQ-5D index of 0.76. After relevant adjustments, factors associated with low HRQoL were sarcopenia (p<0.001), cognitive function (p<0.001), dependence in ADL (p=0.002), low plasma-albumin (p=0.002) and impaired nutritional status (p=0.038).

Conclusion: This study displays evidence that modifiable conditions like sarcopenia and malnutrition are related to HRQoL in older NH residents. Such findings indicate a potential for physical exercise, including muscle training, and improved nutritional routines, including protein supplementation, to enhance nursing home care. Future studies, in larger NH populations, on exercise and nutrition for effects on HRQoL are needed.

Keywords: EQ5D-5L; nutritional status; physical function; quality of life; sarcopenia.

Grants and funding

This study was supported by Gamla Tjänarinnor as well as the Danone Nutricia Research, Utrecht, the Netherlands, who also provided the study products.