Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/15982
Functional decline in nursing home residents: A prognostic study
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ISSN: 1932-6203
WOS ID: 000401314300092
Scopus EID: 2-s2.0-85019131557
PMID: 28493946
Embase PUI: L616080528
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2017-05-11Document type
research articleCitation
Jerez-Roig J, De Brito Macedo Ferreira LM, Torres De Araujo JR, Lima KC. Functional decline in nursing home residents: A prognostic study. PLoS One. 2017 May 11;12(5):e0177353.Abstract
Aim To verify the probability of maintaining functional capacity in basic activities of daily living and identify the prognostic factors of functional decline in institutionalized older adults. Methods A longitudinal study is presented herein, with 5 waves every 6 months, throughout 2 years (2013-2015), conducted with individuals >= 60 years old in 10 nursing homes in the city of Natal-RN (Brazil). Functional capacity was assessed by the items 'eating', 'personal hygiene', 'dressing', 'bathing', 'transferring', 'toileting' and 'walking', through a 5-item Likert scale. Sociodemographic, institution-related and health-related variables were considered to establish the baseline. Time dependent variables included continence decline, cognitive decline, increase in the number of medication, and incidences of falls, hospitalizations and fractures. The actuarial method, the log-rank test and Cox's regression were applied as statistical methods. Results The cumulative probability of functional maintenance was 78.2% (CI 95%: 72.8 - 82.7%), 65.1% (CI 95%: 58.9 - 70.5%), 53.5% (CI 95%: 47.2 - 59.5%) and 44.0% (CI 95%: 37.7 - 50.2%) at 6, 12, 18 and 24 months, respectively. Predicting factors for functional decline were: severe cognitive impairment (HR = 1.96; p = 0.001), continence decline (HR = 1.85; p = 0.002) and incidence of hospitalizations (HR = 1.62; p = 0.020), adjusted by the incidence of depression, age, education level, presence of chronic diseases and low weight. Conclusions The cumulative probability of maintaining functional capacity in institutionalized older adults was only 44% at the 2-year follow-up. Prognostic factors for functional decline included severe cognitive impairment, continence decline and incidence of hospitalizations.
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https://dx.doi.org/10.1371/journal.pone.0177353MeSH
PrognosisAged, 80 and over
Activities of Daily Living
Aged
Male
Probability
Female
Humans
Institutionalization
Nursing Homes
Survival Rate
Models, Theoretical
DeCS
Modelos TeóricosTasa de Supervivencia
Humanos
Casas de Salud
Probabilidad
Institucionalización
Pronóstico
Actividades Cotidianas
Anciano
Anciano de 80 o más Años
Femenino
Masculino