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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 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.

SUBMITTER: Pastor-Barriuso R

PROVIDER: S-EPMC7672974 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study.

Pastor-Barriuso Roberto R Padrón-Monedero Alicia A Parra-Ramírez Lina M LM García López Fernando J FJ Damián Javier J

BMC geriatrics 20201118 1

<h4>Background</h4>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.<h4>Methods</h4>A representative cohort of 382 nursing home re ...[more]

PMID: 33208087

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Project description:ObjectiveTo describe the frequency and timing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection in a convenience sample of skilled nursing facility (SNF) residents with and without confirmed SARS-CoV-2 infection.DesignRetrospective analysis of SNF electronic health records.SettingQualitative SARS-CoV-2 antibody test results were available from 81 SNFs in 16 states.ParticipantsSix hundred and sixty nine SNF residents who underwent both polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2.MeasurementsPresence of SARS-CoV-2 antibodies following the first positive PCR test for confirmed cases, or first PCR test for non-cases.ResultsAmong 397 residents with PCR-confirmed infection, antibodies were detected in 4 of 7 (57.1%) tested within 7-14 days of their first positive PCR test; in 44 of 47 (93.6%) tested within 15-30 days; in 182 of 219 (83.1%) tested within 31-60 days; and in 110 of 124 (88.7%) tested after 60 days. Among 272 PCR negative residents, antibodies were detected in 2 of 9 (22.2%) tested within 7-14 days of their first PCR test; in 41 of 81 (50.6%) tested within 15-30 days; in 65 of 148 (43.9%) tested within 31-60 days; and in 9 of 34 (26.5%) tested after 60 days. No significant differences in baseline resident characteristics or symptoms were observed between those with versus without antibodies.ConclusionsThese findings suggest that vulnerable older adults can mount an antibody response to SARS-CoV-2, and that antibodies are most likely to be detected within 15-30 days of diagnosis. That antibodies were detected in a large proportion of residents with no confirmed SARS-CoV-2 infection highlights the complexity of identifying who is infected in real time. Frequent surveillance and diagnostic testing based on low thresholds of clinical suspicion for symptoms and/or exposure will remain critical to inform strategies designed to mitigate outbreaks in SNFs while community SARS-CoV-2 prevalence remains high.

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Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study.

Publications

Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study.

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