BACKGROUND: The aim of our study was to identify independent predictors of functional decline in older nursing home (NH) residents, taking into account both resident and facility characteristics. METHODS: Longitudinal observational study involving 1,760 older (≥65 y) residents of NH participating in the SHELTER* study (57 NH in eight countries). All residents underwent a comprehensive geriatric assessment using the interRAI LTCF. Functional decline was defined as an increase of at least one point in the MDS Long Form ADL scale during a 1 year follow-up. Facility and country effects were taken into account. RESULTS: During the study period 891 (50.6%), NH residents experienced ADL decline. Residents experiencing ADL decline were older, had lower disability at baseline, were more frequently affected by severe dementia and by urinary incontinence, and used more antipsychotics. In the mixed-effect logistic regression model, factors independently associated with a higher risk of functional decline were dementia and urinary incontinence, whereas the presence of a geriatrician was a protective factor. CONCLUSIONS: Both resident and facility characteristics are associated with the risk of functional decline in NH residents. Increasing the quality of healthcare by involving a geriatrician in residents' care might be an important strategy to improve the outcome of this vulnerable population.
BACKGROUND: The aim of our study was to identify independent predictors of functional decline in older nursing home (NH) residents, taking into account both resident and facility characteristics. METHODS: Longitudinal observational study involving 1,760 older (≥65 y) residents of NH participating in the SHELTER* study (57 NH in eight countries). All residents underwent a comprehensive geriatric assessment using the interRAI LTCF. Functional decline was defined as an increase of at least one point in the MDS Long Form ADL scale during a 1 year follow-up. Facility and country effects were taken into account. RESULTS: During the study period 891 (50.6%), NH residents experienced ADL decline. Residents experiencing ADL decline were older, had lower disability at baseline, were more frequently affected by severe dementia and by urinary incontinence, and used more antipsychotics. In the mixed-effect logistic regression model, factors independently associated with a higher risk of functional decline were dementia and urinary incontinence, whereas the presence of a geriatrician was a protective factor. CONCLUSIONS: Both resident and facility characteristics are associated with the risk of functional decline in NH residents. Increasing the quality of healthcare by involving a geriatrician in residents' care might be an important strategy to improve the outcome of this vulnerable population.
Authors: Elisa Belén Cortés Zamora; Marta Mas Romero; María Teresa Tabernero Sahuquillo; Almudena Avendaño Céspedes; Fernando Andrés-Petrel; Cristina Gómez Ballesteros; Victoria Sánchez-Flor Alfaro; Rita López-Bru; Melisa López-Utiel; Sara Celaya Cifuentes; Laura Plaza Carmona; Borja Gil García; Ana Pérez Fernández-Rius; Rubén Alcantud Córcoles; Belén Roldán García; Luis Romero Rizos; Pedro Manuel Sánchez-Jurado; Carmen Luengo Márquez; Mariano Esbrí Víctor; Matilde León Ortiz; Gabriel Ariza Zafra; Elena Martín Sebastiá; Esther López Jiménez; Gema Paterna Mellinas; Esther Martínez-Sánchez; Alicia Noguerón García; María Fe Ruiz García; Rafael García-Molina; Juan de Dios Estrella Cazalla; Pedro Abizanda Journal: Am J Geriatr Psychiatry Date: 2022-01-22 Impact factor: 4.105
Authors: Pau Farrés-Godayol; Javier Jerez-Roig; Eduard Minobes-Molina; Meltem Yildirim; Miriam Molas-Tuneu; Anna Escribà-Salvans; Sandra Rierola-Fochs; Montse Romero-Mas; Miriam Torres-Moreno; Laura Coll-Planas; Joanne Booth; Maria Giné-Garriga Journal: Int J Environ Res Public Health Date: 2022-01-28 Impact factor: 4.614