Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study
Abstract Background Social engagement (SE) has been consistently shown to improve survival among community-dwelling older people, but the evidence in nursing home residents is inconclusive and prone to short-term reverse causation and confounding by major health determinants. Our main objective was...
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doaj-bcd29a44f9c14e4a88d47089db2e8da42020-11-25T04:02:59ZengBMCBMC Geriatrics1471-23182020-11-012011910.1186/s12877-020-01876-2Social engagement within the facility increased life expectancy in nursing home residents: a follow-up studyRoberto Pastor-Barriuso0Alicia Padrón-Monedero1Lina M. Parra-Ramírez2Fernando J. García López3Javier Damián4National Center for Epidemiology, Institute of Health Carlos IIINational Center for Epidemiology, Institute of Health Carlos IIINational Center for Epidemiology, Institute of Health Carlos IIINational Center for Epidemiology, Institute of Health Carlos IIINational Center for Epidemiology, Institute of Health Carlos IIIAbstract Background Social engagement (SE) has been consistently shown to improve survival among community-dwelling older people, but the evidence in nursing home residents is inconclusive and prone to short-term reverse causation and confounding by major health determinants. Our main objective was to study the potential causal effect of within-the-facility social engagement (SE) on long-term all-cause mortality in care home residents. Methods A representative cohort of 382 nursing home residents in Madrid without severe physical and cognitive impairments at baseline was followed up for 10-year all-cause mortality. Standardized mortality curves for residents with low/null, moderate, and high levels of SE at baseline were estimated using Kaplan-Meier methods and spline-based survival models with inverse probability of exposure weights conditional on baseline sociodemographic characteristics, facility features, comorbidity, and disability. Standardized 5-year mortality risks and median survival times were compared across levels of SE. Results The baseline prevalences of low/null, moderate, and high SE were 36, 44, and 20%, respectively. Compared with residents with low/null SE at baseline, the standardized differences (95% confidence intervals) in 5-year mortality risk were − 2.3% (− 14.6 to 10.0%) for moderately engaged residents and − 18.4% (− 33.8 to − 2.9%) for highly engaged residents. The median survival time increased by 0.4 (− 1.4 to 2.2) and 3.0 (0.8 to 5.2) years, respectively. Conclusion Residents with high SE within the nursing home had an 18% lower 5-year mortality risk and a 3-year increase in their median survival, as compared with residents with similar health determinants but low/null SE. The development of adequate tailored intervention programs, addressed to increase SE in nursing home residents, could improve their long-term survival, in addition to expected gains in quality of life.http://link.springer.com/article/10.1186/s12877-020-01876-2Cohort studyInverse probability weightingMortalityNursing homesSocial engagement.S |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Roberto Pastor-Barriuso Alicia Padrón-Monedero Lina M. Parra-Ramírez Fernando J. García López Javier Damián |
spellingShingle |
Roberto Pastor-Barriuso Alicia Padrón-Monedero Lina M. Parra-Ramírez Fernando J. García López Javier Damián Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study BMC Geriatrics Cohort study Inverse probability weighting Mortality Nursing homes Social engagement.S |
author_facet |
Roberto Pastor-Barriuso Alicia Padrón-Monedero Lina M. Parra-Ramírez Fernando J. García López Javier Damián |
author_sort |
Roberto Pastor-Barriuso |
title |
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
title_short |
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
title_full |
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
title_fullStr |
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
title_full_unstemmed |
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
title_sort |
social engagement within the facility increased life expectancy in nursing home residents: a follow-up study |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2020-11-01 |
description |
Abstract Background Social engagement (SE) has been consistently shown to improve survival among community-dwelling older people, but the evidence in nursing home residents is inconclusive and prone to short-term reverse causation and confounding by major health determinants. Our main objective was to study the potential causal effect of within-the-facility social engagement (SE) on long-term all-cause mortality in care home residents. Methods A representative cohort of 382 nursing home residents in Madrid without severe physical and cognitive impairments at baseline was followed up for 10-year all-cause mortality. Standardized mortality curves for residents with low/null, moderate, and high levels of SE at baseline were estimated using Kaplan-Meier methods and spline-based survival models with inverse probability of exposure weights conditional on baseline sociodemographic characteristics, facility features, comorbidity, and disability. Standardized 5-year mortality risks and median survival times were compared across levels of SE. Results The baseline prevalences of low/null, moderate, and high SE were 36, 44, and 20%, respectively. Compared with residents with low/null SE at baseline, the standardized differences (95% confidence intervals) in 5-year mortality risk were − 2.3% (− 14.6 to 10.0%) for moderately engaged residents and − 18.4% (− 33.8 to − 2.9%) for highly engaged residents. The median survival time increased by 0.4 (− 1.4 to 2.2) and 3.0 (0.8 to 5.2) years, respectively. Conclusion Residents with high SE within the nursing home had an 18% lower 5-year mortality risk and a 3-year increase in their median survival, as compared with residents with similar health determinants but low/null SE. The development of adequate tailored intervention programs, addressed to increase SE in nursing home residents, could improve their long-term survival, in addition to expected gains in quality of life. |
topic |
Cohort study Inverse probability weighting Mortality Nursing homes Social engagement.S |
url |
http://link.springer.com/article/10.1186/s12877-020-01876-2 |
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