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. 2025 Dec 27:15394492251403393.
doi: 10.1177/15394492251403393. Online ahead of print.

Factors Affecting the Quality of Life of Institutionalized Older Adults With Dementia

Masahiro Tanaka  1 , Jun-Ichi Uemura  2 , Miki Tanikaga  3 , Jumpei Mizuno  4 , Yasuhisa Nakamura  1
Affiliations

Factors Affecting the Quality of Life of Institutionalized Older Adults With Dementia

Masahiro Tanaka et al. OTJR (Thorofare N J). .

Abstract

This study aimed to determine the effects of cognitive function, activities of daily living independence, behavioral and psychological symptoms of dementia (BPSD), and the diversity of activities and participation on the quality of life (QOL) of institutionalized older adults with dementia. The causal structure of these variables was also explored using structural equation modeling (SEM) based on our hypotheses. Conducted between August 2021 and December 2024, this cross-sectional study comprised 103 older adults admitted to care facilities in Japan. The SEM results and path diagram showed that BPSD had a direct negative effect on QOL, whereas the diversity of activities and participation had direct and indirect positive effects. Cognitive function had an indirectly positive effect on QOL via the diversity of activities and participation. Therefore, reducing BPSD and providing a diversity of activities and participation may contribute to improving the QOL.

Keywords: dementia; long-term care; participation; quality of life; structural equation modeling (SEM).

Plain language summary

Factors Affecting the Quality of Life of Institutionalized Older Adults With DementiaCurrently, dementia has no definitive cure, and it is necessary to ensure a suitable quality of life (QOL) for people living with dementia as their functional abilities decline. The QOL of institutionalized older adults with dementia is reportedly lower than that of community-dwelling older adults; thus, their QOL should be improved. This study aimed to clarify the effects of the following on the QOL of institutionalized older adults with dementia: cognitive function, cc (activity of daily living [ADL]) independence, behavioral and psychological symptoms in dementia (BPSD; peripheral symptoms of dementia), and the diversity of activities and participation on the QOL. Analyses revealed that BPSD has a direct negative impact on QOL. The diversity of activities and participation had direct and indirect positive impacts. Cognitive function had a positive impact on QOL indirectly through the diversity of activities and participation. Conversely, cognitive function and ADL independence did not affect QOL. The results indicate that reducing BPSD and providing various activities and participation can enhance the QOL of institutionalized older adults with dementia, informing future rehabilitation efforts.

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