International Psychogeriatrics

Research Article

Comorbidity, health status, and quality of life in institutionalized older people with and without dementia

Salomé Martín-Garcíaa1, Carmen Rodríguez-Blázqueza2a5 c1, Iluminada Martínez-Lópeza1, Pablo Martínez-Martína3a5 and Maria João Forjaza4a6 on behalf of the Spanish Research Group on Quality of Life and Ageing

a1 EULEN Socio-sanitary services, Madrid, Spain

a2 National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain

a3 Research Unit, CIEN Foundation, Institute of Health Carlos III, Alzheimer Center Reina Sofia Foundation, Madrid, Spain

a4 National School of Public Health, Institute of Health Carlos III, Madrid, Spain

a5 CIBERNED, Madrid, Spain

a6 REDISSEC, Bilbao, Spain


Background: Comorbidity in older adults may lead to lower perceived health status and a decrease in quality of life (QoL). The objective of this study is to analyze the relationship between comorbidity, health status, QoL, and dementia in institutionalized older adults.

Methods: Cross-sectional, multicenter study in residential care settings in Spain. Two groups of institutionalized older adults of 60 years of age and older were compared: 234 persons with normal cognitive function and 525 with dementia according to DSM-IV-TR criteria. Assessments included: sociodemographic questionnaire, EQ-5D index for health-related QoL, Visual Analogue Scale (EQ-VAS) for health status, number of chronic medical conditions (comorbidity), Barthel Index for functional independence, and Short Portable Mental Status Questionnaire.

Results: The group with dementia presented significantly worse QoL, health, and functional status than people without dementia. The most prevalent chronic medical conditions were musculoskeletal (72.3%), followed by genito-urinary disorders (60.2%). Controlling for age and sex, people with dementia and higher comorbidity exhibited lower EQ-VAS scores; however, no significant difference was found for the EQ-5D index. The health conditions that contributed the most to the EQ-VAS differences between the dementia and non-dementia groups were sight, oral, and genito-urinary problems.

Conclusions: When compared to older adults with no dementia, people with dementia and high comorbidity reported the most compromised health status, especially in those with sight, oral, and genito-urinary problems. These differences should be taken into consideration when selecting strategies to maintain and improve the health status of older adults in residential care settings.

(Received November 07 2012)

(Reviewed December 13 2012)

(Revised March 04 2013)

(Accepted March 05 2013)

(Online publication April 11 2013)

Key words:

  • comorbidity;
  • health status;
  • quality of life;
  • older adults;
  • dementia


c1 Correspondence should be addressed to: Carmen Rodriguez-Blazquez, National Center of Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain. Phone: +34-91-822-2657; Fax: +34-91-387-7815. Email: