Functional health, environmental engagement and mental wellbeing as interrelated components of healthy ageing: a cross-sectional comparative study of community-dwelling and institutionalized older adults

Abstract

Healthy ageing is commonly defined in relation to functional ability, intrinsic capacity and environmental context. However, less is known about how environmental engagement, mental wellbeing, physical functional indicators and religious/spiritual resources combine into healthy ageing profiles across residential settings. This study examined these associations in community-dwelling and institutionalized older adults. This cross-sectional, exploratory comparative study included 136 older adults in Hungary: 78 community-dwelling participants and 58 residents of long-term care institutions. Environmental engagement was operationalized as self-reported weekly frequency of spending at least 30 min in natural environments. Mental wellbeing was assessed using the World Health Organization Five Well-Being Index (WHO-5), religiosity using the Centrality of Religiosity Scale (CRS), movement quality using the Functional Movement Screen (FMS), and muscular strength using handgrip dynamometry. Analyses included group comparisons, correlations, multiple regression, exploratory cluster analysis and an exploratory thresholded correlation network. Community-dwelling participants were younger and showed more frequent nature exposure, higher wellbeing and better FMS scores than institutionalized participants, whereas institutionalized participants reported higher religiosity. Nature exposure was associated with WHO-5 wellbeing ( r  = 0.220, p  = 0.010) and FMS ( r  = 0.320, p  < 0.001). FMS was associated with handgrip strength ( r  = 0.320, p  < 0.001). The wellbeing regression model explained only a modest proportion of variance (R² = 0.086), and the association between nature exposure and wellbeing did not remain statistically significant after adjustment (β = 0.162, p  = 0.072). A three-cluster solution was retained as the most interpretable exploratory phenotype structure, despite k = 2 showing somewhat stronger numerical cluster-validity indices. In the exploratory network, FMS had the highest centrality, while religiosity was peripheral. The findings suggest that healthy ageing in this sample was characterized by multidimensional, heterogeneous and interrelated profiles rather than residential status alone. Functional movement quality and environmental engagement were associated with several healthy ageing indicators, but causal mechanisms cannot be inferred. The results should be interpreted as exploratory and hypothesis-generating, warranting confirmation in larger longitudinal and intervention studies.