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Health determinants and survival in nursing home residents in Europe: Results from the SHELTER study
Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Catholic University of Rome, Italy.
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Number of Authors: 13
2018 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 107, p. 19-25Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2018. Vol. 107, p. 19-25
Keyword [en]
Health determinants, Nursing home, Survival, Older people, Vaccination
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:su:diva-152485DOI: 10.1016/j.maturitas.2017.09.014ISI: 000418982900006PubMedID: 29169575OAI: oai:DiVA.org:su-152485DiVA, id: diva2:1181568
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-02-09Bibliographically approved

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