Function-Focused Person-Environment Fit for Long-Term Care Residents with Dementia: Impact on Apathy

Background and Objectives: Apathy is a common symptom in dementia and is associated with rapid cognitive decline, poor quality of life, and higher mortality. Lawton's Competence and Environmental Press model suggests that an individual's behavior and affect are influenced by the fit of their functional abilities with the environmental demands. Yet, empirical evidence on the association between person-environment (P-E) fit and apathy is lacking. Thus, this study examined the relationship between P-E fit and apathy in dementia. Specifically, this study focused on the extent the physical environment fits individual functional limitations. Research Design and Methods: This is a cross-sectional study using the baseline data from long-term care residents with dementia. The sample included 199 residents with moderate-to-severe cognitive impairment from 4 assisted living and 4 nursing homes. Function-focused P-E fit was measured using the Housing Enabler scale. Apathy was measured using the Apathy Evaluation Scale. Multilevel linear models were used to analyze the relationship between P-E fit and apathy. Results: Findings revealed that greater P-E fit, specifically indoor environment, was significantly associated with lower apathy after controlling for age, gender, and years living in the facility. Yet, the association became not significant after controlling for individual physical function. Discussion and Implications: Findings support the association between function-focused P-E fit and apathy, but the association is no longer significant after physical function is adjusted. Future research may explore other aspects of P-E fit and the impact of social and organizational environment on apathy in dementia.