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Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study.
J Am Med Dir Assoc. 2016 06 01; 17(6):525-9.JA

Abstract

OBJECTIVE

"Lack of energy" or anergia is a common complaint associated with adverse outcomes in older people. There is a lack of knowledge on this symptom in the nursing home (NH) setting. The aim of this study was to investigate whether lack of energy was associated with hospitalization and mortality in NH residents.

DESIGN

Longitudinal observational cohort study.

SETTING AND PARTICIPANTS

A total of 575 NH residents (72% women) in 13 French NHs from the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR) study cohort.

MEASUREMENTS

Lack of energy was measured at the baseline visit as part of the 10-item Geriatric Depression Scale. Unadjusted and adjusted Cox proportional hazard regression models were performed to test the association of lack of energy with hospitalization events and mortality over 12 months of follow-up.

RESULTS

The mean age of the study sample was 86.3 (SD = 7.5) years. At the baseline, 250 (43.5%) residents complained about lack of energy. Overall, 192 (33.4%) individuals experienced at least 1 hospitalization event and 98 (17.0%) died during the 12-month follow-up. Lack of energy was significantly associated with a higher risk of hospitalization (HR 1.35; 95% CI 1.02-1.80; P = .03), even after adjustment for potential confounders (HR 1.41; 95% CI 1.04-1.91; P = .02). No statistically significant association was found between lack of energy and 12-month mortality.

CONCLUSION

Lack of energy is a predictor of hospitalization in older people living in NHs. It may be considered a relevant clinical feature for identifying individuals at risk of adverse health outcomes, thus potentially serving as a screening tool for subsequently conducting a comprehensive geriatric assessment in this highly vulnerable and complex population.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Zengarini E
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. Electronic address: el.zengarini@hotmail.it.
Hoogendijk EO
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Department of Epidemiology & Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Pérez-Zepeda MU
Clinical and Epidemiological Research Department, National Geriatric Institute, Mexico City, Mexico.
Ruggiero C
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy.
Mecocci P
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy.
Vellas B
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INSERM UMR1027, Université Toulouse III - Paul Sabatier, Toulouse, France.
Cesari M
Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; INSERM UMR1027, Université Toulouse III - Paul Sabatier, Toulouse, France.

MeSH

AdolescentAgedAged, 80 and overFemaleForecastingFrail ElderlyGeriatric AssessmentHospitalizationHumansLongitudinal StudiesMaleMortalityNursing HomesProportional Hazards ModelsRisk Assessment

Pub Type(s)

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

Language

eng

PubMed ID

26969535

Citation

Zengarini, Elisa, et al. "Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study." Journal of the American Medical Directors Association, vol. 17, no. 6, 2016, pp. 525-9.
Zengarini E, Hoogendijk EO, Pérez-Zepeda MU, et al. Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study. J Am Med Dir Assoc. 2016;17(6):525-9.
Zengarini, E., Hoogendijk, E. O., Pérez-Zepeda, M. U., Ruggiero, C., Mecocci, P., Vellas, B., & Cesari, M. (2016). Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study. Journal of the American Medical Directors Association, 17(6), 525-9. https://doi.org/10.1016/j.jamda.2016.02.005
Zengarini E, et al. Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study. J Am Med Dir Assoc. 2016 06 1;17(6):525-9. PubMed PMID: 26969535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lack of Energy and Negative Health-Related Outcomes in Nursing Home Residents: Results From the INCUR Study. AU - Zengarini,Elisa, AU - Hoogendijk,Emiel O, AU - Pérez-Zepeda,Mario U, AU - Ruggiero,Carmelinda, AU - Mecocci,Patrizia, AU - Vellas,Bruno, AU - Cesari,Matteo, Y1 - 2016/03/09/ PY - 2015/10/31/received PY - 2016/02/05/revised PY - 2016/02/05/accepted PY - 2016/3/13/entrez PY - 2016/3/13/pubmed PY - 2017/11/29/medline KW - Lack of energy KW - hospitalization KW - mortality KW - nursing home SP - 525 EP - 9 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 17 IS - 6 N2 - OBJECTIVE: "Lack of energy" or anergia is a common complaint associated with adverse outcomes in older people. There is a lack of knowledge on this symptom in the nursing home (NH) setting. The aim of this study was to investigate whether lack of energy was associated with hospitalization and mortality in NH residents. DESIGN: Longitudinal observational cohort study. SETTING AND PARTICIPANTS: A total of 575 NH residents (72% women) in 13 French NHs from the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR) study cohort. MEASUREMENTS: Lack of energy was measured at the baseline visit as part of the 10-item Geriatric Depression Scale. Unadjusted and adjusted Cox proportional hazard regression models were performed to test the association of lack of energy with hospitalization events and mortality over 12 months of follow-up. RESULTS: The mean age of the study sample was 86.3 (SD = 7.5) years. At the baseline, 250 (43.5%) residents complained about lack of energy. Overall, 192 (33.4%) individuals experienced at least 1 hospitalization event and 98 (17.0%) died during the 12-month follow-up. Lack of energy was significantly associated with a higher risk of hospitalization (HR 1.35; 95% CI 1.02-1.80; P = .03), even after adjustment for potential confounders (HR 1.41; 95% CI 1.04-1.91; P = .02). No statistically significant association was found between lack of energy and 12-month mortality. CONCLUSION: Lack of energy is a predictor of hospitalization in older people living in NHs. It may be considered a relevant clinical feature for identifying individuals at risk of adverse health outcomes, thus potentially serving as a screening tool for subsequently conducting a comprehensive geriatric assessment in this highly vulnerable and complex population. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/26969535/Lack_of_Energy_and_Negative_Health_Related_Outcomes_in_Nursing_Home_Residents:_Results_From_the_INCUR_Study_ DB - PRIME DP - Unbound Medicine ER -