Quality of life and associated factors in institutionalized older adults: implications for gerontological nursing. Analytical study

Abstract

Introduction: Population aging and the rise in chronic diseases demand strengthening strategies to promote the well-being of institutionalized older adults. The FUMAT scale enables the assessment of quality of life across eight dimensions of well-being. Objective: To analyze the factors associated with the quality-of-life profile of institutionalized older adults. Material and Methods: A cross-sectional analytical study was conducted with 250 permanent residents (≥3 months) of a nursing home in Bucaramanga, Colombia. Individuals aged 60 years or older with a reliable informant were included; those with terminal illness, acute psychiatric disorders, or clinical instability were excluded. The FUMAT scale, Barthel Index, PULSES profile, FRAIL scale, Downton Fall Risk Index, and the Short Portable Mental Status Questionnaire (SPMSQ) were applied. Descriptive and bivariate analyses were performed using Pearson's chi-square test, Fisher’s exact test, and the Mann–Whitney U test. Multivariate analysis was conducted using binary logistic regression. Data were processed using Stata v17. Results: The lowest-scoring dimensions were material well-being and interpersonal relationships, whereas rights and social inclusion achieved the highest scores. Physical activity and participation in productive activities were associated with better scores on the FUMAT Quality-of-Life Index (FUMAT-QOLI). In the multivariate model, cognitive impairment (OR=0.34; 95% CI: 0.12–0.91) and motor impairment (OR=0.30; 95% CI: 0.14–0.64) significantly reduced the likelihood of belonging to the highest FUMAT-QOLI tertile; physical and productive activities showed a positive but non-significant trend. Discussion: The findings indicate that functional capacity and cognitive integrity are key determinants of well-being among institutionalized older adults. Low scores in material well-being and interpersonal relations suggest resource and social support limitations, requiring institutional intervention. The association between activity and well-being supports the implementation of active aging programs. Conclusion: Promoting autonomy, cognitive stimulation, and social integration is essential to improve quality of life.