Community-based housing models and quality of life among older adults: A systematic review and meta-analysis of cross-sectional and longitudinal studies.

BACKGROUND: Alternative community-based housing models (CBHMs) for aging in place (AIP) have emerged in recent years as options to residential or nursing home care. These models aim to support older adults while enhancing quality of life (QoL). OBJECTIVE: To determine the association between different CBHMs and QoL in older adults. METHODS: A systematic search was conducted through November 2025 in PubMed, Scopus, Cochrane Central, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. Pooled standardized mean differences (p-ES) were calculated to examine cross-sectional and longitudinal associations between CBHMs and QoL. We also explored whether these associations varied by CBHM type based on care level. RESULTS: A total of 10 longitudinal/cohort studies and cross-sectional studies were included in the systematic review and meta-analysis. The p-ES between CBHM and overall QoL was 0.04, 95% CI (-0.26 to 0.33), -0.33, 95% CI (-0.78 to 0.12) for physical QoL, and 0.05, 95% CI (-0.08 to 0.17) for mental QoL. CONCLUSIONS: This systematic review and meta-analysis found that CBHM type, based on level of care, did not significantly improve overall QoL among older adults. However, policymakers should interpret these findings cautiously when planning alternative social and health resources to traditional nursing homes or developing alternative housing solutions for AIP.