Health determinants and survival in nursing home residents in Europe: Results from the SHELTER study

Nicola Magnavita, Silvia Giovannini, Walter Ricciardi, Roberto Bernabei, Graziano Onder, Davide Liborio Vetrano, Agnese Collamati, Andrea Poscia, Agnieszka Sowa, Eva Topinkova, Harriet Finne-Soveri, Henriëtte G. Van Der Roest, Beata Tobiasz-Adamczyk

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective The care processes directed towards institutionalized older people needs to be tailored on goals and priorities that are relevant for this specific population. The aim of the present study was (a) to describe the distribution of selected health determinants in a sample of institutionalized older adults, and (b) to investigate the impact on survival of such measures. Design Multicentre longitudinal cohort-study. Setting 57 nursing homes (NH) in 7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non-EU country (Israel). Participants 3036 NH residents participating in the Services and Health for Elderly in Long TERm care (SHELTER) study. Measurements We described the distribution of 8 health determinants (smoking habit, alcohol use, body mass index [BMI], physical activity, social participation, family visits, vaccination, and preventive visits) and their impact on 1-year mortality. Results During the one-year follow up, 611 (20%) participants died. Overweight (HR 0.79; 95% C.I. 0.64–0.97) and obesity (HR 0.64; 95% C.I. 0.48–0.87) resulted associated with lower mortality then normal weight. Similarly, physical activity (HR 0.67; 95% C.I. 0.54–0.83), social activities (HR 0.63; 95% C.I. 0.51–0.78), influenza vaccination (HR 0.66; 95% C.I. 0.55–0.80) and pneumococcal vaccination (HR 0.76 95% C.I. 0.63–0.93) were associated with lower mortality. Conversely, underweight (HR 1.28; 95% C.I. 1.03–1.60) and frequent family visits (HR 1.75; 95% C.I. 1.27–2.42) were associated with higher mortality. Conclusions Health determinants in older NH residents depart from those usually accounted for in younger and fitter populations. Ad hoc studies are warranted in order to describe other relevant aspects of health in frail older adults, with special attention on those institutionalized, with the ultimate goal of improving the quality of care and life.
Original languageEnglish
Pages (from-to)19-25
Number of pages7
JournalMaturitas
Volume107
DOIs
Publication statusPublished - 2018

Keywords

  • Biochemistry, Genetics and Molecular Biology (all)
  • Health determinants
  • Nursing home
  • Obstetrics and Gynecology
  • Older people
  • Survival
  • Vaccination

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