Prediction of negative outcomes; falls; frailty; mortality; nursing homes
Abstract :
[en] OBJECTIVE:
The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year.
METHODS:
We studied 662 participants from the Sample of Elderly Nursing home Individuals: An Observational Research (SENIOR) cohort aged 83.2 ± 8.99 years, including 484 (72.5%) women and living in nursing homes. Among this cohort, 584 and 565 participants, respectively, were monitored over 12 months for mortality assessment and for occurrence of falls (ie, by mean of their medical records). Each patient was subjected to a clinical examination at baseline, during which many original clinical characteristics were collected. Stepwise regression analyses were carried out to predict mortality and falls.
RESULTS:
Among the participants included in the study, 93 (15.9%) died and 211 (37.3%) experienced a fall during the 1-year of follow-up. After adjustment, none of the definitions of frailty assessed predicted the 1-year occurrence of negative health outcomes. When comparing the clinical characteristics of deceased participants and those still alive, being a man (OR = 1.89; 95% CI: 1.19-3.01; P = .002) and being diagnosed with sarcopenia (OR = 1.7; 95% CI: 1.1-2.92; P = .03) were independent factors associated with 1-year mortality. Other independent factors that were significantly associated with the 1-year occurrence of falls were the results obtained with the Tinetti test (OR = 0.93; 95% CI: 0.87-0.98; P = .04), with the grip strength test (OR = 0.95; 95% CI: 0.90-0.98, P = .03), and with the isometric strength test of elbow extensors (OR = 0.93; 95%CI: 0.87-0.97; P = .04).
CONCLUSIONS:
Within the operational definitions of frailty assessed, none is sufficiently sensitive to predict the occurrence of falls and deaths at 1 year among nursing home residents. Globally, the frequency of undesirable health outcomes seems to be higher among participants with lower muscle strength and mobility. Medical strategy or adapted physical activity, with the aim of improving specific isometric muscle strength and mobility could potentially, but significantly, reduce the occurrence of falls and even deaths.
Disciplines :
Public health, health care sciences & services Geriatrics
Author, co-author :
Buckinx, Fanny ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Croisier, Jean-Louis ; Université de Liège - ULiège > Département des sciences de la motricité > Kinésithérapie générale et réadaptation
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Lenaerts, Céline ; Université de Liège - ULiège > Master sc. santé publ., à finalité
Brunois, Théo ; Université de Liège - ULiège > Master sc. santé publ., à finalité
Rygaert, Xavier ; Université de Liège - ULiège > Master sc. santé publ., à finalité
PETERMANS, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Service de gériatrie
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Prediction of the Incidence of Falls and Deaths Among Elderly Nursing Home Residents: The SENIOR Study.
Publication date :
2018
Journal title :
Journal of the American Medical Directors Association
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