Health-related quality of life among nursing home residents compared to community-dwelling and general older populations: influence of sociodemographic determinants and common chronic diseases

Health-related quality of life (QoL) is a key indicator of health and care quality in geriatric nursing homes. We assessed QoL in 190 residents of three nursing homes with questionnaires developed by the World Health Organization (WHO), the WHOQOL-BREF and the WHOQOL-OLD, and compared them to two control groups. The mean global QoL score was 60.1 in nursing homes, slightly higher than in a comparable home-living group (54.8; P = 0.085) but significantly lower than in the general population (72.4; P < 0.001). The highest rated domain was fear of death and dying (81.2), the lowest autonomy (56.3). Multivariate analyses showed that female sex and surviving cancer improved some WHOQOL-BREF domains, while older age, higher care level, diabetes, and stroke reduced certain WHOQOL-OLD domains. Overall, QoL in nursing homes was high, even higher than among home-living peers, but lower than in healthier, younger populations. Fear of the end of life was low; autonomy declined most. Stroke notably reduced QoL, whereas long-term cancer survival was linked to better outcomes.