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Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: a survival analysis.
Arch Gerontol Geriatr. 2013 Jan-Feb; 56(1):250-7.AG

Abstract

Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Bürge E
Physical Therapy Department, University of Applied Sciences, Western Switzerland, Geneva, Switzerland. elisabeth.burge@hesge.ch
von Gunten A
No affiliation info available
Berchtold A
No affiliation info available

MeSH

Activities of Daily LivingAge FactorsAgedAged, 80 and overBody Mass IndexCognition DisordersDepressionFemaleHumansMaleMiddle AgedNursing HomesPostural BalanceProportional Hazards ModelsRisk FactorsSex FactorsSurvival AnalysisUrinary Incontinence

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23022056

Citation

Bürge, Elisabeth, et al. "Factors Favoring a Degradation or an Improvement in Activities of Daily Living (ADL) Performance Among Nursing Home (NH) Residents: a Survival Analysis." Archives of Gerontology and Geriatrics, vol. 56, no. 1, 2013, pp. 250-7.
Bürge E, von Gunten A, Berchtold A. Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: a survival analysis. Arch Gerontol Geriatr. 2013;56(1):250-7.
Bürge, E., von Gunten, A., & Berchtold, A. (2013). Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: a survival analysis. Archives of Gerontology and Geriatrics, 56(1), 250-7. https://doi.org/10.1016/j.archger.2012.09.001
Bürge E, von Gunten A, Berchtold A. Factors Favoring a Degradation or an Improvement in Activities of Daily Living (ADL) Performance Among Nursing Home (NH) Residents: a Survival Analysis. Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):250-7. PubMed PMID: 23022056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors favoring a degradation or an improvement in activities of daily living (ADL) performance among nursing home (NH) residents: a survival analysis. AU - Bürge,Elisabeth, AU - von Gunten,Armin, AU - Berchtold,André, Y1 - 2012/09/27/ PY - 2012/05/16/received PY - 2012/09/06/revised PY - 2012/09/07/accepted PY - 2012/10/2/entrez PY - 2012/10/2/pubmed PY - 2013/5/4/medline SP - 250 EP - 7 JF - Archives of gerontology and geriatrics JO - Arch Gerontol Geriatr VL - 56 IS - 1 N2 - Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents. SN - 1872-6976 UR - https://www.unboundmedicine.com/medline/citation/23022056/Factors_favoring_a_degradation_or_an_improvement_in_activities_of_daily_living__ADL__performance_among_nursing_home__NH__residents:_a_survival_analysis_ DB - PRIME DP - Unbound Medicine ER -