The home environment and quality of life-related outcomes in advanced old age: findings of the ENABLE-AGE project.

With the present research, we further exploited the potential of the ENABLE-AGE Project, more precisely the Swedish and German data. We hypothesised that the magnitude of accessibility problems (MAP) in the home environment and external housing-related control beliefs (HCB) play a substantial role for a range of outcomes related to quality of life. Our sample at T1 consisted of 847 single-living and community-dwelling individuals aged between 80 and 89 years, from urban regions in Sweden and Germany, 636 of whom were re-assessed 1 year later. MAP was measured with the Housing Enabler instrument, while external HCB assessment was based on a questionnaire proved useful in earlier research. Outcomes were assessed with established measures of ADL independence/dependence, general well-being, positive and negative affect and depression. Cross-sectional regressions underscored that MAP and external HCB were rather consistently associated with outcomes, with MAP being more strongly associated with ADL independence/dependence and external HCB more strongly with well-being related outcomes. Furthermore, significant and marginally significant interaction terms underscored that being high in external HCB in the situation of large MAP was linked with more negative outcomes, while external HCB did not play a role in the situation of small MAP. In the longitudinal regression analysis, MAP at T1 was predictive for T1-T2 change in ADL independence/dependence and depression, while external HCB did not show substantial relations with any change in outcomes. Our study underlines and qualifies substantial relations between objective and perceived person-physical environment measures and a range of outcomes. Such evidence is required to further improve housing-oriented prevention and intervention strategies in advanced old age.