Objectives: First, to seek if sociodemographic and health factors contribute differentially to the explanation of loneliness in institutionalized and noninstitutionalized older adults; and second, to analyze the influence of institutionalization on loneliness. Method: This work was based on two surveys of older adults aged 60 years or more in Spain. A group of 234 community-dwelling people and 234 nursing homes residents were selected (n = 468). Logistic regression models were applied using the six-item De Jong Gierveld Loneliness Scale as dependent variable. Results: Depression was associated with loneliness in both populations. Sex and marital status contributed to explain loneliness among those living at home, whereas gathering with family, friends, and neighbors showed a significant effect in the institutionalized group. Institutionalization per se showed a strong effect on loneliness. Discussion: Findings have potential implications for targeting older adults at risk for loneliness.

Objectives: Active ageing, considered from the perspective of participation in leisure activities, promotes life satisfaction and personal well-being. The aims of this work are to define and explain leisure activity profiles among institutionalized older adults, considering their sociodemographic characteristics and objective and subjective conditions in relation to their quality of life. Methods: Two samples of institutionalized people aged 60 and over were analysed together: 234 older adults without dementia and 525 with dementia. Sociodemographic, economic, family and social network, and health and functioning variables were selected. Cluster analysis was applied to obtain activity profiles according to the leisure activities, and ordinal regression models were performed to analyse factors associated to activity level. Results: The sample was clustered into three groups of people: active (27%), moderately active (35%) and inactive people (38%). In the final regression model (Nagelkerke pseudo R² = 0.500), a higher level of activity was associated with better cognitive function (Pfeiffer scale), self-perceived health status and functional ability, as well as with a higher frequency of gathering with family and friends, and higher educational level. Conclusion: The decline in physical and mental health, the loss of functional capabilities and the weakening of family and social ties represent a significant barrier to active ageing in a context of institutionalization.

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.

To assess the psychometric quality of an instrument designed to measure functional independence (Functional Independence Scale [FIS]) in several activities of daily living domains and to be applied by trained non-health-related interviewers. The study was carried out in the autonomous region of Madrid in community-dwelling elders. We performed a cross-sectional validation study. In addition to the FIS, Pfeiffer's questionnaire, the Depression Subscale of the Hospital Anxiety and Depression Scale, the Comorbidity Index, the Barthel Index, and EQ-5D were used. These measures were cross-sectionally applied to community-dwelling elders (n=500) and outpatients in a general hospital (n=100) aged 65 years. The following FIS psychometric attributes were analyzed: acceptability, scaling assumptions, internal consistency, construct validity, and precision. A fully computable FIS total score was obtained in 94.3% of the subjects. A ceiling effect (60.65%), but no floor effect (0.22%) was evident in the community-dwelling elders. No floor or ceiling effects were detected in the hospital sample. Scaling assumptions and internal consistency were satisfactory (item-total correlations: 0.57-0.91; Cronbach's alpha: 0.94). Factor analysis identified three factors that explained 74.3% of the variance. Indexes of convergent, internal, and known-groups validity were satisfactory. The scale's precision, determined by the standard error of measurement (2.49; 95%CI=4.88), was also satisfactory. The FIS is an easy-to-use instrument with appropriate metric attributes. This scale can be usefully applied in broad samples of non-institutionalized elders by non-health related personnel.