Objectives:

The objective of this longitudinal study was to compare the trajectory of subjective quality of life in 2 groups of older adults: those who entered a nursing home and those who remained living in the community with similar clinical conditions.

Method:

PAQUID is a prospective population-based study. It included, at baseline, 3777 community-dwelling participants aged 65 years and over. Participants were followed-up for up to 27 years. Among people living at home at baseline, 2 groups were compared: participants who entered a nursing home over a 20-year follow-up (n = 528) and those who remained community dwellers (n = 2273). We used latent process mixed models to estimate the relationship between mean trajectory of subjective quality of life and admission into a nursing home. We computed univariate and multivariate models taking into account potential confounders (age, gender, education, income, comorbidities, dementia, disability and depression).

Results:

Nursing home placement was significantly associated with a drop in quality of life between the last visit before and after institutionalization. Nevertheless, we found no difference in quality of life trajectory after this initial drop.

Conclusion:

Older adults exhibit an acute drop in quality of life after nursing home admission, probably reflecting the associated psychological distress. Even though their quality of life does not go back to pre-admission levels, the residents do not show a steeper decline when compared to the “natural” evolution of quality of life in older adults living in the community, which suggests a relative adaptation to their new living conditions.

中文翻译：

---

进入疗养院前后的生活质量轨迹：一项纵向研究

目标：

这项纵向研究的目的是比较两组老年人的主观生活质量轨迹：那些进入疗养院的人和那些仍然生活在具有相似临床条件的社区的人。

方法：

PAQUID 是一项基于人群的前瞻性研究。在基线时，它包括 3777 名 65 岁及以上的社区居民参与者。参与者被跟踪长达27年。在基线时住在家里的人中，比较了 2 组：在 20 年的随访中进入疗养院的参与者（n = 528）和仍然是社区居民的参与者（n = 2273）。我们使用潜在过程混合模型来估计主观生活质量的平均轨迹与入住疗养院之间的关系。我们计算了考虑潜在混杂因素（年龄、性别、教育、收入、合并症、痴呆、残疾和抑郁）的单变量和多变量模型。

结果：

疗养院安置与住院前后最后一次访问之间的生活质量下降显着相关。尽管如此，我们发现在最初的下降之后，生活质量轨迹没有差异。

结论：

入住疗养院后，老年人的生活质量急剧下降，这可能反映了相关的心理困扰。尽管他们的生活质量没有回到入院前的水平，但与居住在社区的老年人生活质量的“自然”演变相比，居民并没有表现出更大幅度的下降，这表明相对适应他们新的生活条件。