Table 2.

Characteristics of cross-sectional studies on the association between social connectedness/engagement and health outcomes among older adults living in congregate long-term care settings

(Author, Year) Location	Objective	Data Source (Years of data)	# of Residents and Description	Sample Description % Female Age (years) % Marital status indicators % Race/Ethnicity
(Beck & Ovesen, 2003) Denmark	Estimate the influence of social engagement and dining location on dietary intake	Minimum Data Set (MDS) 2.0 data collected by registered dietician and cross-checked with nurses and medical records Energy intake derived from 4-day estimated dietary records (Not reported)	40 residents in 2 nursing homes	Female: 82% Mean age: 83 (Range: 80-85) Marital status not reported. Race/ethnicity not reported.
(Beerens et al., 2016) Netherlands	Investigate which aspects of daily life are related to quality of life	Ecological momentary assessment of residents (Not reported)	115 residents with dementia living in 18 long-term care facilities	Female: 75.0% Mean age: 83.8±7.8 Widowed: 66% Race/ethnicity not reported.
(Bitzan, 1998) Wisconsin, USA	Examine the association between nursing home roommate relationships and subjective well-being	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 2 hours held over 2 sessions) Convenience sample (Not reported)	31 residents sharing rooms with non-relatives for a ≥ 2 months	Female: 93.5% Mean age: 83 (range: 51-99) Marital status not reported. All were white; most were of German and Polish descent.
(Björk et al., 2017) Sweden	Estimate the extent to which engagement in everyday activities is associated with thriving	Structured questionnaires administered to care staff who knew the residents best (2013-2014)	4,831 residents in 172 nursing homes	Female: 67.8% Mean age: 85.5±7.8 Marital status not reported. Race/ethnicity not reported.
(Carpenter, 2002) Louisiana, USA	Evaluate associations between dimensions of social support on psychological well-being	Structured questionnaires administered to patients; staff reported ADL assessment (Not reported)	32 newly admitted to a Transitional Care Unit at a Veterans Affairs Medical Center	Female: 0% Mean age: 67.8±8.5 Married/Partnered: 41.0% Widowed: 19.0% Divorced/separated/never: 40.0% African American: 63.0% Euro-American: 37.0%
(H. T. Chang, Liu, L. F., Chen, C. K., Hwang, S. J., Chen, L. K., & Lu, F. H, 2010) Taiwan	Evaluate quality of life and related factors of senior veterans	Structured questionnaires administered by investigator to residents, face-to-face (Not reported)	260 residents aged ≥65 years without cognitive and hearing impairments, and living in 4 veterans’ homes for >3 months	Female: 0% Mean age: 82.9±4.7 Married: 18.8% Widowed: 18.8% Divorced/never: 59.2% Others: 3.1% Race/ethnicity not reported.
(L. Chang, 2015) Taiwan	Examine whether leisure self-determination and social support were related to acute and chronic stress	Structured questionnaires administered by research staff to residents, face-to-face (2012)	141 residents living in 2 nursing homes who were aged ≥65 years, no mental health conditions, and able to participate in leisure activities	Female: 62.4% Mean age: 79.4±7.1 Married: 7.8% Widowed: 72.4% Divorced: 8.5% Unmarried: 11.3% Race/ethnicity not reported.
(L. C. Chang, 2018) Taiwan	Examine association between leisure self-determination and social support types on stress	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 35 minutes) (Not reported)	139 residents living in 2 nursing homes who were aged ≥65 years, no mental health conditions, and able to participate in leisure activities	Female: 63.3% Mean age: 79.4±7.1 Married: 7.9% Widowed: 72.7% Divorced/never: 19.4% Race/ethnicity not reported.
(Chao, 2019) Taiwan	Determine the association between activity participation and mental health	Structured questionnaires administered by research staff to residents, face-to-face Stratified probability sample (2014)	634 residents living in 155 long-term care facilities >3 months, aged ≥60 years, able to understand and respond	Female: 60.0% Mean age: 78.3±9.1 Married: 23.7% Race/ethnicity not reported.
(Y. Chen, Ryden, M. B., Feldt, K., & Savik, K, 2000) Minnesota, USA	Examine social interaction and physical, verbal, and sexual aggression	Research staff retrieved demographic and case mix information from medical records and administered several questionnaires to residents. Research staff guided nurses and nurses’ aides who completed key instruments based on observations of residents over a 3-week period. (Not reported)	129 residents living in 3 nursing homes and expected to stay >6 months who were cognitively impaired with Mini-Mental Status Exam scores ≤24 and consistently aggressive	Female to male ratio: 2.5 to 1 Mean age: 85.6±7.8 Married: 29.5% Widowed: 58.9% Never: 11.6% Race/ethnicity not reported.
(Y. M. Chen et al., 2009) Taiwan	Explore the relationship of urinary incontinence and physical function, cognitive status, depressive symptoms and quality of life	MDS 2.0 and structured questionnaires administered by trained nurse to residents, face-to-face (2006)	594 residents living in 1 veterans nursing home aged ≥65 years	Female: 0% Mean age: 80.9±5.3 Marital status not reported. Race/ethnicity not reported.
(Y. Chen, Lin, L., Chuang, L., & Chen, M, 2017) Taiwan	Examine the extent to which perceived social support and depression mediate the association between functional ability and spiritual well-being	Structured questionnaires administered by research staff to residents, face-to-face (2014-2015)	377 residents living in 11 long-term care facilities ≥1 month, aged ≥65 years, with no hearing, visual, or cognitive impairments	Female: 61% Mean age: 79.1±10.4 Married: 25.7% Widowed: 56.0% Divorced/never: 17.0% Others: 1.3% Race/ethnicity not reported.
(Y. Chen, Lin, K., Wu, C., Chen, C., & Hsieh, Y, 2020) Taiwan	Identify determinants of quality of life	Self-administered questionnaires with researchers’ guidance when needed Convenience sample (2016-2017)	210 residents living in 1 long-term care facility ≥ 6 months, aged ≥65 years, able to answer questions, and scored ≥ 24 on Mini-Mental State Examination	Female: 58.1% Mean age: 80.3±9.74 Married: 37.1% Widowed: 51.4% Divorced/never: 11.4% Min Nan: 85.7% Hakka: 4.8% Aborigines: 1.0% Mainland Chinese: 8.6%
(Y. Chen et al., 2020) Wuhan, Yichang, Huanggang, Hangzhou, Jinhua, Haikou, Sanya, Xi’an, Xianyang, Shenzhen, Beijing, Chengdu, Chongqing, China	Investigate the extent to which perceived social support and self-rated health mediate the relationship between pain and depression	Structured questionnaires administered by research staff to residents, face-to-face Convenience sample (2017-2018)	2,154 residents living in 38 nursing homes aged ≥60 years, spoke Mandarin, without cognitive and severe hearing impairments	Female: 64.2% Mean age: 82.0±7.0 Married: 34.8% Divorced/widowed/never: 65.2% Race/ethnicity not reported.
(Cheng, Lee, & Chow, 2010) Hong Kong, China	Investigate the extent to which structural and functional social support promote psychological well-being	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 30 minutes) (Not reported)	71 residents living in 7 nursing homes with any activity of daily living limitation and Mini-Mental State Exam score ≥18	Female: 80.3% Mean age: 80.9±6.14 Marital status not reported. Race/ethnicity not reported.
(Chipps & Jarvis, 2015) South Africa	Investigate the association between social capital and mental well-being	Structured questionnaires administered by research staff to residents, face-to-face Purposeful sampling by management of residents who may be socially isolated (2013)	75 residents living in 1 residential care facility, aged ≥60 years and cognitively intact	Female: 77.3% 60 – 75 years: 41.3% 76-100 years: 58.7% Widowed: 60.0% Divorced/never: 40.0% White: 77.3% Indian: 22.7%
(J. Cho et al., 2012) Georgia, USA	Examine the relationship of functional indicators, psychological and situational factors and fatigue	Secondary analysis of data from The Georgia Centenarian Study (Poon, 2007) Structured questionnaires administered by research staff to residents, face-to-face (Not reported)	62 residents living in long-term care facilities aged ≥ 98 years and cognitively intact	Characteristics of residents living in long-term care not provided separately from community dwelling participants.
(Choi et al., 2018) South Korea	Identify contributing factors of aggressive behaviors	Secondary data analysis of a random sample of participants of a nationally representative sample Trained nurses and social workers working in the nursing homes completed the assessment form (2013)	1,447 residents living in 91 nursing homes ≥ 1 month, aged ≥65 years	Female: 77.4% Mean age: 82.8 ± 7.5 Married: 18.8% Race/ethnicity not reported.
(Cohen-Louck & Aviad, 2020) Israel	Examine the relationship between family support and social engagement and suicidal tendency levels and meaning in life	Structured questionnaires administered by research staff to residents, face-to-face (Not reported)	92 independently functioning residents of 7 nursing homes and assisted living facilities	Female: 63.0% Mean age: 81.8 ± 7.4 Married: 19.6% Widowed: 60.8% Race/ethnicity not reported.
(Cohen-Mansfield & Marx, 1992) Maryland, USA	Examine the relationship between social network characteristics and dimensions of agitation	Charge nurses and social workers completed the questionnaires (Not reported)	408 residents living in 1 large nursing home	Female: 77.5% Mean age: 85 (range: 70-99) Married: 19.1% Race/ethnicity not reported.
(Commerford & Reznikoff, 1996) New York, USA	Examine the relationship of perceived social support on depression and self-esteem	Structured questionnaires administered by the investigator to residents, face-to-face (Not reported)	83 residents living in 4 nursing homes with ≤ 2 errors on the Mental Status Questionnaire	Female: 77.1% Mean age: 80.7±10.5 Marital status not reported. White: 84.3% African American:14.5% Hispanic: 1.2%
(Creighton, Davison, & Kissane, 2019) Australia	Identify biopsychosocial factors associated with anxiety	Structured questionnaires administered by research staff to residents, face-to-face; research staff abstracted items from charts, and interviewed nursing staff using structured questionnaires (2015-2016)	178 residents living in 12 nursing homes ≥3 months, aged ≥65 years, Mini-Mental State Exam score ≥18, with no/mild cognitive impairment, and no schizophrenia or bipolar affective disorder	Female: 66.3% Mean age: 85.4±7.4 Married: 19.1% Widowed: 52.8% Divorced/separated/never: 27.0% Race/ethnicity not reported.
(Cuijpers & Van Lammeren, 1999) Netherlands	Explore the relationship between chronic illness and depression	Structured questionnaires administered by trained interviewers to residents, face-to-face; research staff interviewed nursing staff about resident’s chronic illnesses (nurses could refer to medical records) (Duration on average 1 hour) (Not reported)	424 residents living in 10 residential homes who scored ≥ 18 on Mini-Mental State Examination	Female: 78.5% Age groups: <70: 2.1% 70-80: 23.7% 81-90: 57.8% >90: 16.4% Married: 10.5% Widowed: 74.3% Divorced: 3.8% Never: 11.3% Race/ethnicity not reported.
(Cummings, 2002) Southeastern USA	Examine the effect of functional impairment and social support on well-being	Structured questionnaires administered by trained interviewers to residents, face-to-face (Duration on average 20 minutes) (Not reported)	57 residents in an assisted-living facility who were without cognitive impairment or communication problems	Female: 78.6% Mean age: 83.7±7.4 Married: 19.6% White: 100%
(Cummings & Cockerham, 2004) Southeastern USA	Explore factors associated with depression and life satisfaction	Structured questionnaires administered by trained interviewers to residents, face-to-face (Duration on average 30 minutes) (Not reported)	145 residents of 2 assisted living facilities able to communicate, and no cognitive impairment	Female: 77.4% Mean age: 84.4±7.2 Married: 16.9% Caucasian: 100%
(Damian et al., 2008) Spain	Describe the physical, mental, and social factors associated with self-rated health	Structured questionnaires administered by trained geriatricians to residents, their main caregivers, and their physician (or nurse), face-to-face Multistage cluster sampling (1998-1999)	669 residents living in 49 nursing homes	Female: 75.0% Mean age: 83.4±7.3 Marital status not reported. Race/ethnicity not reported.
(Degenholtz et al., 2006) California, New York, New Jersey, Minnesota, Florida, Maryland, USA	Determine the association between resident and facility level factors and quality of life	Interviews with residents to collect quality of life, linked with data from MDS and Online Survey and Certification Automated Record (1999-2000; 2001)	2,829 residents living in 101 nursing facilities, aged ≥65 years, able to communicate, and in English	Female: 74.0% Mean age: 84.0±8.1 Marital status not reported. White: 89.0%
(Doyle, 1995) Australia	Examine the effect of nursing staff turnover, frequency of visitors, and the presence or absence of close friends on depressive symptoms	Self-administered questionnaires reported by residents and nursing staff (director of nursing) (Not reported)	165 residents living in 24 nursing homes, Mini-Mental State Exam score >18	Female: 75.0% Mean age: 82.0±8.6 Married: 19.0% Widowed: 59.0% Race/ethnicity not reported.
(Drageset et al., 2008) Norway	Quantify the relationship between social support and health-related quality of life	Structured questionnaires administered by the principal investigator to residents, face-to-face (2004-2005)	227 residents living in 30 nursing homes > 6 months, aged ≥ 65 years, cognitively intact, and capable of carrying out a conversation	Female: 72.2% Age groups: 65-74: 8.8% 75-84: 34.4% 85-94: 45.8% ≥95: 11.0% Married or cohabitating: 16.7% Widowed: 63.4% Divorced, unmarried: 19.8% Race/ethnicity not reported.
(Duncan, Killian, & Lucier-Greer, 2017) Arkansas, USA	Explore the extent to which perceived social support mediates the association between leisure activity engagement and ill-being	Structured questionnaires administered by research staff to residents, face-to-face (Duration between 45-60 minutes) (Not reported)	110 older adults living in 13 long-term care facilities, Mini-Mental State Exam scores ≥25	Female: 68.1% Mean age: 80.6±9.5 Married/Partnered: 17.3% Widowed: 44.5% Divorced/separated/never: 20.9% White: 95.5%
(El Zoghbi, 2014) Lebanon	Description of nutritional status and its correlates	Structured questionnaires administered by research staff to residents, face-to-face (2012)	111 residents living in 3 long stay institutions longer than 4 weeks and aged ≥65 years	Female: 50.5% Mean age: Woman: 78.1 ± 1.02 Men: 74.5 ± 1.09 Married: 27.0% Widow: 24.3% Divorced: 12.6% Single: 24.3% Race/ethnicity not reported.
(Fernández-Mayoralas, 2015) Spain	Evaluate the association between leisure activity profiles and quality of life	Structured questionnaires administered to residents by health professionals working at the nursing homes who were supervised by researchers (2008 and 2010)	759 residents living in 14 nursing homes aged ≥60 years	Female: 77.3% Mean age: 84.2±7.2 Married/Partnered: 16.2% Widowed: 60.5% Divorced/separated/never: 22.8% Race/ethnicity not reported.
(Ghusn et al., 1996) Texas, USA	Identify factors that enhance later life satisfaction	Structured questionnaires administered by research staff to residents, face-to-face (1993)	78 residents living in 2 Veterans Affairs nursing homes	Female: 0% Age groups: 44-54: 6.4% 55-64: 28.2% 65-74: 41.0% 75-84: 20.5% > 85: 3.8% Married/Partnered: 30.8% Widowed: 15.4% Divorced/separated/never: 53.8% African American: 30.8% Caucasian: 64.1% Hispanic: 5.1%
(Guse, 1999) Manitoba, Canada	Explore factors related to quality of life	Structured questionnaires (with 3 open-ended questions) administered by research staff to residents, face-to-face (1997)	32 permanent residents aged ≥55 years from 1 long-term care facility	Female: 34.0% Age groups: 65-74: 28.0% 75-84: 59.0% >84: 13.0% Married/Partnered: 34.4% Widowed: 46.9% Divorced/separated/never: 18.8% Race/ethnicity not reported.
(Haugan, Moksnes, & Løhre, 2016) Norway	Investigate the association between perceived nurse-patient interaction and quality of life	Structured questionnaires administered by research staff to residents, face-to-face (2008 and 2009)	202 residents living in 44 nursing homes > 6 months and cognitively intact	Female: 72.3% Mean age: 85.6 Marital status not reported. Race/ethnicity not reported.
(Hjaltadóttir et al., 2012) Iceland	Investigate association between residents’ health status and functional profile and quality indicators	MDS (no admission assessments) (2003-2009)	3,694 residents living in nursing homes	Female: 66.2% Mean age: 84.3±8.2 Marital status not reported. Race/ethnicity not reported
(Hollinger-Smith & Buschmann, 2000) Illinois, USA	Examine factors associated with failure to thrive syndrome	Structured questionnaires administered by research staff to residents and medical records (Not reported)	130 residents living in 2 nursing homes for ≥2 weeks, aged ≥65 years, able to read and write in English	Female: 58.5% Mean age: 76.6±8.7 Widowed: 53.1% Single: 23.1% Caucasian: 83.8%
(Hsiao & Chen, 2018) Taiwan	Investigate the associations among individual, family, and extrafamilial factors and depression	Secondary analysis of Vulnerability and Social Exclusion among Different Groups of Disadvantaged Elderly in an Aging Society: Phenomena and Strategies Project Structured questionnaires administered by research staff, face-to-face (2007)	327 residents living in 39 care institutions, aged ≥65 years, cognitively intact with mild to no physical impairment	Female: 48.3% Mean age: 82.1±7.5 No spouse: 74.6% Race/ethnicity not reported.
(Hsu & Wright, 2014) Taiwan	Examine the association between frequency, meaningfulness, and enjoyment of social activities and depressive symptoms	Structured questionnaires, research staff read the questions to participants needing assistance, face-to-face (Not reported)	174 residents living in 13 long-term care facilities, aged ≥65 years, cognitively intact, able to speak Mandarin or Taiwanese, not bedridden, no severe speech/hearing impairment, no dementia or psychiatric disorder	Female: 54.0% Mean age: 78.6±7.8 Married/Partnered: 24.7% Widowed: 63.2% Divorced/separated/never: 12.1% Race/ethnicity not reported.
(Jang, Park, Dominguez, & Molinari, 2014) Florida, USA	Explore how social engagement interacts with functional disability in predicting depressive symptoms	Structured questionnaires administered by research staff to residents, face-to-face (2004)	150 residents living in 17 assisted living facilities, aged ≥60 years, without severe cognitive impairment	Female: 77.3% Mean age: 82.8±9.4 Married: 10.7% Race/ethnicity not reported.
(Jao et al., 2018) Pennsylvania, USA	Examine the association between social interactions and affect	Research staff extract information from medical charts, video recorded residents for 20 minutes in morning and afternoon over 5 consecutive days, and interviewed them (2005-2008)	126 residents living in 12 nursing homes, aged ≥65 years with dementia (Mini-Mental State Exam score 7-24), who spoke English, unstable medical illness	Female: 77.0% Mean age: 86.1±6.0 Married/Partnered: 17.6% Widowed: 72.8% Divorced/separated/never: 9.5% Caucasian: 88.1% African American: 11.9%
(Kang, 2012) Iowa, USA	Evaluate the association between social depression and functional and behavioral variables	MDS 2.0 Research staff extracted medications from medical charts (2008-2009)	153 residents living in 17 nursing homes aged ≥ 60 years with a diagnosis of Alzheimer’s disease or related dementias in their medical chart	Female: 64.7% Mean age: 85.0±7.3 Married: 35.3% Widowed: 55.6% Divorced/separated: 3.3% Never: 5.9% White: 100%
(Kasser & Ryan, 1999) New York, USA	Investigate the effects of autonomy support and relatedness on well-being	Structured questionnaires, research staff aided residents if needed, face-to-face (Duration on average 34 minutes) (Not reported)	50 residents living in 1 nursing home, aged >60 years, competent to give informed consent	Female: 78.0% Mean age: 83 (range: 70-99) Marital status not reported. Race/ethnicity not reported.
(Kehyayan, Hirdes, Tyas, & Stolee, 2016) Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Saskatchewan, Canada	Identify predictors of long-term care facility residents self-reported quality of life	Structured quality of life questionnaires administered by trained surveyors to residents (face-to-face) linked to MDS 2.0 (2010)	928 residents in 48 long-term care facilities, without severe cognitive impairment, who spoke English	Female: 65.5% Age groups: <65: 10.6% 65-84: 46.1% ≥85: 43.3% Married: 21.0% Race/ethnicity not reported.
(Keister, 2006) Midwestern USA	Determine if person and situation factors were associated with health outcomes during the first week in nursing home	Structured questionnaires to residents (face-to-face) Convenience sample (1999-2000)	114 residents who moved into 11 nursing homes in the last week and were expected to live there at least 8 weeks, aged ≥65 years, who understood and spoke English and had not been diagnosed with major depression in past 4 months	Female: 74% Mean age: 82.3±7.7 Widowed: 61.4% White: 92%
(Kroemeke & Gruszczynska, 2016) Poland	Examine the association between social support and subjective well-being	Self-administered questionnaires distributed by research staff (Not reported)	180 nursing home residents aged ≥60 years, cognitively intact, and no acute illness	Female: 67.5% Mean age: 79.1±9.1 Married: 17% Divorced/widowed/never: 83% Race/ethnicity not reported.
(Kwok, Yeung, & Chung, 2011) Hong Kong, China	Examine the moderating role of social support on the relationship between physical functional impairment and depressive symptoms	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 25 minute) Convenience sample (Not reported)	187 residents living in 2 nursing homes, aged ≥65 years, with Mini-Mental Exam scores ≥ 18	Female: 71.1% Age groups: 65-75: 23.0% 76-85: 40.1% >85: 36.9% Marital status not reported. Race/ethnicity not reported.
(G. E. Lee, 2010) South Korea	Identify predictors of nursing home life adjustment	Structured questionnaires administered by research staff to residents, face-to-face (2007)	156 residents living in 7 nursing homes aged >65 years, cognitively intact and healthy enough to participate	Female: 80.1% Mean age: 79.1±6.0 Marital status not reported. Race/ethnicity not reported.
(H. Lee et al., 2017) Michigan and Pennsylvania, USA	Examined the relationship between staff–resident interactions and resident psychological well-being	Secondary analysis from a multisite study on wandering (Algase, 2008) Videotaped residents 12 20-minute observation periods on 2 non-consecutive days, between 8:00 A.M. and 8:00 P.M. Random cluster sampling (Not reported)	110 residents living in 17 nursing homes and 6 assisted living facilities, ≥ 65 years with dementia (Mini-Mental State Exam score <24, English-speaking, not wheelchair-bound, and adequate vision/hearing	Female: 72.7% Mean age: 84±6.9 Marital status not reported. Caucasian: 70.0%
(Leedahl, Chapin, & Little, 2015) Kansas, USA	Examine relationships between social integration and mental and functional health	Structured questionnaires administered by research staff to residents, face-to-face (Duration not longer than 1 hour) Two-stage multilevel sampling (Not reported)	140 long-stay residents living in 30 nursing homes, ≥ 65 years, long-term stay, able to consent, Mini-Mental Exam Score >12, and Cognitive Performance Scale <3	Female: 74.3% Mean age: 83.1±9.0 Married: 15.0% Widowed: 55.0% White: 92.7%
(Li et al., 2015) New York, USA	Examine factors associated with daytime sleep	MDS 2.0 (2005 to 2010)	300 residents living in 1 nursing home for more than 3 months	Female: 72% Mean age: 86.9±7.0 Marital status not reported. White: 99% Hispanic or Black: 1%
(Lin, Wang, & Huang, 2006) Taiwan	Examine the relationship between depressive symptoms and length of residency, health status and social support	Structured questionnaires administered by research staff to residents, face-to-face Convenience sampling (Not reported)	138 residents living in 8 nursing homes at least 6 months, aged ≥ 65 years, and cognitively intact	Female: 53.6% Mean age: 78.0±7.1 Married: 25.4% Race/ethnicity not reported.
(Liu, Xue, Xue, & Hou, 2018) Xinjiang, China	Evaluate the relationship between health literacy, self-care agency, social support and health status	Structured questionnaires administered by research staff to residents, face-to-face (2011-2012)	1,452 participants aged between 60 and 99 years from 44 nursing homes	None reported
(Maenhout et al., 2020) Belgium	Investigate the relationship between personal, organizational, activity-related factors, and social satisfaction on quality of life	Structured questionnaires administered by research staff to residents, face-to-face (Duration 2-4 hours to complete, 2 sessions in a week) Stratified random sample (Not reported)	171 residents living in 73 nursing homes for > 1 month, aged ≥ 75 years, cognitively healthy, able to understand and answer questions	Female: 73.1% Mean age: 85.4±5.9 Married: 15.8% Widowed: 71.3% Divorced/separate/never: 11.7% Race/ethnicity not reported.
(Martin et al., 2006) California, USA	Evaluate factors associated with excessive daytime sleeping	Structured behavioral observations were performed for one minute every 15 minutes from 9:00 am–5:00 pm for 2 days (1999-2002)	492 residents from 4 nursing homes	Female: 80.5% Mean age not reported. Marital status not reported. Race/ethnicity not reported.
(Marventano et al., 2015) Spain	Evaluate the association between characteristics of residents with dementia and quality of life and residential care centers characteristics with quality of life	Nurses, occupational therapists, directors of nursing care, medical staff, caregivers, and proxies completed different components of the survey and chart review (2010)	429 residents living in 14 nursing care homes aged ≥60 years with dementia	Female: 82.1% Mean age: 85.8±6.7 Married: 17.5% Race/ethnicity not reported.
(M. McCabe et al., 2021) Australia	Evaluate the contribution of resident choice and the staff–resident relationship on resident quality of life	Secondary analysis from a randomized trial on consumer directed care (M. P. McCabe, Beattie, E., Karantzas, G., Mellor, D., Sanders, K., Busija, L., Goodenough, B., Bennett, M., Von Treuer, K., & Byers, J, 2018) Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 30-45 minutes) (2018-2020)	604 residents living in 33 nursing homes ≥2 months, possessed adequate English communication skills, without severe cognitive impairment	Female: 64.4% Mean age: 85.4±7.7 Marital status not reported. Race/ethnicity not reported.
(Mitchell & Kemp, 2000) California, USA	Examine effects of health status and social involvement on quality of life	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 1 hour) Stratified random sample (Not reported)	201 residents living in 55 assisted living facilities, alert without cognitive impairment	Female: 74.0% Mean age: 81±9.6 Widowed: 69.0% Non-Hispanic White: 96.0%
(Morrison-Koechl et al., 2021) Canada	Explores the effects of psychosocial factors on energy intake	Secondary analysis of data from the Making the Most of Mealtimes study (Keller et al., 2017) Direct observations of mealtime experience, structured interviews with care partners, resident chart reviews, and measures of nutritional care Convenience sampling (Not reported)	604 residents from 32 long-term care homes	Female: 68.2% Mean age: 86.8±7.8 Marital status not reported. Race/ethnicity not reported.
(Nie, Hu, Zhu, & Xu, 2020) Hunan, China	Explore risk factors for suicidal ideation	Structured questionnaire Multistage cluster random sample (2018)	817 residents living in 24 nursing homes > 1 year, aged ≥60 years, physically and mentally able to participate, no severe hearing impairment, severe cognitive deficits, language barrier, or terminal illness	Female: 54.0% Mean age: 79.1±8.7 Divorced/loss of a partner/never married: 63.0% Race/ethnicity not reported.
(Onunkwor et al., 2016) Malaysia	Determine the quality of life and its associated factors	Structured questionnaires administered by research staff to residents, face-to-face Stratified random sampling (2014)	203 residents living in 8 elderly homes, aged ≥60 years, able to understand English, Malay, or Chinese, no communication problem or cognitive impairment	Female: 35.5% Mean age: 71.5±6.8 Married: 61.6% Malay: 3.0% India: 8.4% Chinese: 87.1% Others: 1.5%
(Papi, Karimi, Amini Harooni, Nazarpour, & Shahry, 2019) Iran	Determine predictors of sleep disorder	Structured questionnaires, unclear if self-administered or administered by research team Convenience sample (2017)	130 residents from 4 nursing homes aged > 60 years, no cognitive disorders	Female: reported as 66.2% in abstract and 33.8% in results Mean age: 68±7.8 Marital status not reported. Race/ethnicity not reported.
(N. S. Park, 2009) Alabama, USA	Explore the association between social engagement and psychological well-being	Structured questionnaires administered by research staff to residents, face-to-face (Duration on average 60-90 minutes) (2006)	82 residents living in 8 assisted living facilities, aged ≥ 65 years without dementia, capable of understanding and answering questions	Female: 74.4% Mean age: 84.0±6.1 Marital status not reported. Race/ethnicity not reported.
(S. Park & Sok, 2020) South Korea	Examine the relationship between the factors influencing the adaptation ability and life satisfaction	Structured questionnaires distributed by research staff to residents, assistance provided by research staff if needed Random sample (2017)	229 residents living in an elderly care facility for >6 months aged ≥ 65 years, with cognitive ability to respond, with < 2 pharmacological treatments	Female: 67.2% Age groups: 65–74: 14.8% 75–85: 41.5% ≥85: 43.7% Married: 30.1% Race/ethnicity not reported.
(Patra et al., 2017) Greece	Explore the association between social support and depression	Self-administered questionnaires distributed by research staff (2016)	170 residents living in nursing homes aged >60 years, able to read and write in Greek, no psychiatric illness	Female: 66.5% Mean age: 79.5±7.4 Married: 11.8% Race/ethnicity not reported.
(Pramesona & Taneepanichskul, 2018) Indonesia	Investigate risk factors of depression	Structured questionnaires administered by research staff to residents, face-to-face (Duration between 30–45 minutes) (2017)	181 residents living in 3 homes ≥ 1 month, aged ≥60 years, no chronic diseases	Female: 65.7% Mean age: 74.4±7.6 Married: 12.2% Widowed: 56.3% Divorced/separate/never: 31.5% Race/ethnicity not reported.
(Randall et al., 2011) Georgia, USA	Investigate the influence of social relations on health outcomes	Secondary analysis of data from The Georgia Centenarian Study (Poon, 2007) Structured questionnaires administered by research staff to residents, face-to-face (4 sessions, each <2 hours) (2002 – 2005)	105 nursing home residents and 55 assisted living residents, aged ≥ 98 years and cognitively intact	Female: 78.5% Mean age: 99.8±1.7 Married: 6.0% Widowed: 85.0% White: 85.0% African American: 15.0%
(Rozzini et al., 1996) Italy	Describe the association between depression and its factors	Residents were assessed by three geriatricians (Not reported)	56 residents without severe dementia and without neurological conditions	Female: 76.8% Mean age: 81.1±8.6 Marital status not reported. Race/ethnicity not reported.
(Saleh et al., 2017) British Columbia, Canada	Explore the association between social engagement and use of antipsychotics	MDS 2.0 and the Continuing Care Information Management System (2008 – 2011)	2,639 newly admitted long-stay residents aged ≥65 years with Alzheimer’s disease or other dementias	Female: 65.8% Mean age: 83.9±6.8 Married: 35.9% Widowed: 47.9% Divorced/separate/never: 11.8% Race/ethnicity not reported.
(Segal, 2005) Colorado, USA	Assess the relationship of assertiveness, depression, and social support	Anonymous self-administered questionnaires (Not reported)	50 residents of several nursing homes, older adults were free of cognitive impairment	Female: 75.0% Mean age: 74.9±11.9 Marital status not reported. Caucasian: 92.0%
(Smit et al., 2016) Netherlands	Evaluate activity involvement and quality of life	Secondary analysis of data from the Living Arrangements for people with Dementia (LAD) study (Willemse & 11 (11), 2011) MDS 2.0 merged with informal caregiver and nursing home staff surveys (2010-2011)	1,144 residents living in 144 long-term care facilities providing care for people with moderate-to very severe dementia	Female: 75.2% Mean age: 84.2±7.6 Marital status not reported. Race/ethnicity not reported.
(Street, Burge, Quadagno, & Barrett, 2007) Florida, USA	Examine how organizational characteristics, transition experiences, and social relationships impact quality of life	Structured questionnaires administered by research staff to residents, face-to-face (2004-2005)	384 residents living in assisted living facilities, aged ≥65 years, and who were cognitively intact	Female: 73.9% Mean age: 84.2±7.6 Marital status not reported. Race/ethnicity not reported.
(Sun et al., 2017) Shandong, China	Explore the roles of self-esteem, depression, and social support on quality of life	Structured questionnaires administered by investigators to residents, face-to-face (2015)	205 residents living in 5 nursing homes aged ≥60 years, without terminal illnesses, able to communicate, and cognitively intact	Female: 53.7% Mean age: 77.3±7.9 Married: 29.8% Widowed/divorced: 54.6% Single: 15.6% Race/ethnicity not reported.
(Tosangwarn et al., 2017) Thailand	Explore the association between internalized stigma, self-esteem, social support, and coping strategies and depressive symptoms	Structured questionnaires administered by nurse researcher to residents, face-to-face (Duration on average 1 hour) (2015)	128 residents living in 2 care homes, aged ≥60 years who can speak Thai and without severe cognitive impairment or psychological disturbance	Female: 62.5% Mean age: 76.9±7.8 Married/partnered: 3.9% Widowed: 48.5% Divorced/separated: 26.6% Single: 21.1% Race/ethnicity not reported.
(Tseng & Wang, 2001) Taiwan	Explore the role of social support, health status, and family interactions on quality of life	Structured questionnaires distributed by research staff to residents, assistance provided by research staff if needed (Duration on average 30-45 minutes) Convenience sample (Not reported)	161 residents living in 10 nursing homes for > 6 months, aged ≥65 years, with good cognitive function and ability to complete the questionnaire	Female: 40.4% Mean age: 76-74±7.1 Married: 34.1% Widowed: 46.6% Unmarried: 19.3% Race/ethnicity not reported.
(Tu, Lai, Shin, Chang, & Li, 2011) Taiwan	Explore the relationship between health status, social support, and leisure activities with depression	Interviews using structured questionnaires (2007)	309 residents living in 6 long-term care facilities, aged ≥65 years, and capable of answering questions clearly	Female: 61.2% Mean age: 81.6 Spouseless: 80.6% Race/ethnicity not reported.
(Vanbeek et al., 2011) Netherlands	Investigate the relationship between social engagement and depressive symptoms	MDS 2.0, collected over 3 days (2002-2003)	502 residents living in 37 long-term care dementia units	Female: 79.7% Mean age: 85.1±7.1 Married/ partner: 26.7% Race/ethnicity not reported.
(Wahyuni et al., 2019) Indonesia	Evaluate the relationship of social support with depression	Primary data collected with a self-administered questionnaire (Not reported)	20 residents living in 1 nursing home who could read, write, communicate verbally, and cooperate, but who did not have a serious illness	Female: 100% Age group: 60-74: 35.0% 79-90: 60.0% >90: 5.0% Widowed: 95.0% Not married: 5.0% Race/ethnicity not reported.
(J. Wang, Wang, Cao, Jia, & Wu, 2018) Shanghai, China	Examine the association between social support and perceived empowerment and quality of life	Structured questionnaires administered by investigator or research assistant to residents, face-to-face (Duration ~ 45 to 125 minutes) Convenience and purposive sampling (2011-2012)	515 residents living in 9 long term care facilities > 1 month, age ≥60 years, speak Mandarin or Shanghai dialect	Female: 60.4% Mean age: 84.0±5.2 Married: 6.2% Race/ethnicity not reported.
(Wiesmann, Becker, & Hannich, 2017) Germany	Explore association between age, social network, sense of coherence and positive aging	Structured questionnaires administered by investigator or research assistant to residents, face-to-face (Duration on average 42 minutes) (Not reported)	190 residents living in 20 nursing homes ≥ 3 months, aged ≥65 years	Female: 81.6% Mean age: 84.3±7.6 Widowed: 66.7% Race/ethnicity not reported.
(Wu et al., 2017) Shandong, China	Identify factors related to successful aging	Structured questionnaires administered by investigator or research assistant to residents, face-to-face Convenience sample (2015)	205 resident living in 5 nursing homes, aged ≥60 years	Female: 53.7% Mean age: 77.3±7.9 Married: 29.8% Race/ethnicity not reported.
(Wu et al., 2018) Shandong, China	Quantify the relationship between social support and health-related quality of life	Structured questionnaires administered by investigator or research assistant to residents, face-to-face Convenience sample (2015)	205 residents living in 5 nursing homes aged ≥60 years, without terminal illnesses, able to communicate, and cognitively intact	Female: 53.7% Mean age: 77.3±7.9 Married: 29.8% Race/ethnicity not reported.
(Xu et al., 2019) Shandong, China	Investigate the role of child visit frequency and family support in the relationship between the number of children and quality of life	Structured questionnaires administered by investigator or research assistant to residents, face-to-face Convenience sample (2016)	371 residents living in 33 nursing homes for ≥1 month, aged ≥60 years, with Mini-Mental State Exam score≥10, with no sensory impairments affecting participation	Female: 59.3% Mean age: 77.5±8.7 Married and lived together: 8.1% Married and separated: 11.9% Han: 98.1%
(Yeung et al., 2012) Hong Kong, China	Evaluate the mediating effect of institutional peer support on the relationship between physical decline and depressive symptoms	Structured questionnaires administered by research assistant to residents, face-to-face (Duration on average 25 minutes) Convenience sample (2009)	187 residents living in 2 nursing homes without stroke, dementia, or Parkinson’s disease	Female: 71.1% Age group: 65-75: 23% 76-85: 40.1% 85+: 36.9% Married: 38.0% Widowed: 40.0% Single: 22.0% Race/ethnicity not reported.
(Ysseldyk, Haslam Sa Fau - Haslam, & Haslam, 2013) Ontario, Canada	Examine relationships between religion and well-being among older adults	Semi-structured interviews conducted by research staff to residents, face-to-face (Duration ~60 minutes) (2002 & 2008)	42 older adults from 3 care homes	Female: 59.5% Mean age: 86.3±5.8 Marital status not reported. Race/ethnicity not reported.
(Zhang et al., 2018) Shandong, China	Investigate the relationship among social support, physical health, and suicidal thoughts	Structured questionnaires administered by investigator or research assistant to residents, face-to-face Convenience sample (2015)	205 residents living in 5 nursing homes aged ≥60 years, without terminal illnesses, able to communicate, and cognitively intact	Female: 53.7% Mean age: 77.3±7.9 Married: 29.8% Widowed: 53.7% Divorced: 1.0% Single: 15.6% Race/ethnicity not reported.
(Zhu et al., 2020) Hunan, China	Explore risk factors for poor sleep quality	Structured questionnaires administered by trained research staff to residents, face-to-face (Duration 30 to 60 minutes) (2018)	817 residents living in 24 nursing homes for > 1 year and aged > 60 years	Female: 54.0% Age group: 60~69: 16.5% 70~79: 28.4% ≥80: 55.1% Marital Status Stable: 37.0% Race/ethnicity not reported.
(Zurakowski, 2000) USA	Investigate the effects of social support on anomia and self-reported health	Structured questionnaires administered by trained graduate students in nursing to residents, face-to-face Convenience sample	91 residents living in 4 nursing homes	Female: 79.1% Mean age: 79.4±16.2 Married: 8.8% Widowed: 59.3% Divorced: 4.4% Single: 27.5% White: 100%

^*Determined from lead author via email correspondence.

^**Mean Age±SD (years)

^***Described like assisted living homes.