Quality of life in older people with dementia: a multilevel study of individual attributes and residential care center characteristics.

AIM To analyze how the characteristics of institutionalized older people with dementia and residential care centers are associated with the individual's quality of life (QoL). METHODS Data were collected from a survey carried out on 525 elderly people aged 60 years or older in 14 nursing care homes across Spain. Multilevel linear analysis to assess the differences in QoL level between centers and individuals was carried out. RESULTS The characteristics of the individuals that were associated with a higher QoL were functional independence, health status and gathering with family, friends or neighbors. In contrast, higher levels of dementia, depression and the length of institutionalization had a negative effect on QoL. In relation to the residential care center characteristics, the availability of geriatricians was associated with higher QoL, compared with those centers with no geriatricians on staff. In addition, public centers (public ownership and publicly-funded residents) were also associated with higher QoL than private/mixed centers. The multilevel analysis showed that the 16.4% of the differences in QoL was related to residence factors. CONCLUSION These results reflect the importance of the functional, social, mental and residential dimensions in the QoL of older adults with dementia. Actions devoted to improving these key dimensions would contribute to promote the well-being of this vulnerable population.