Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study
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RESEARCH ARTICLE
Open Access
Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study Roberto Pastor-Barriuso1,2, Alicia Padrón-Monedero1,3,4, Lina M. Parra-Ramírez1,5, Fernando J. García López1,4 and Javier Damián1,4*
Abstract Background: Social engagement (SE) has been consistently shown to improve survival among communitydwelling 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 splinebased 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. Keywords: Cohort study, Inverse probability weighting, Mortality, Nursing homes, Social engagement.S
* Correspondence: [email protected] 1 National Center for Epidemiology, Institute of Health Carlos III, Av/ Monforte de Lemos 5, 28029 Madrid, Spain 4 Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are i
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