Health and sociodemographic determinants of excess mortality in Spanish nursing homes during the COVID-19 pandemic: a 2-year prospective longitudinal study

Anna Escriba-Salvans, Javier Jerez-Roig*, Pau Farres-Godayol, Dyego Leandro Bezerra de Souza , Dawn A. Skelton, Eduard Minobes-Molina

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: Age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and overall mortality.

Objective: To estimate overall and COVID-19 mortality parameters and analyse their predictive factors in older people living in nursing homes over a 2-year period.

Design: A 2-year prospective longitudinal multicentre study was conducted between 2020 and 2022.

Setting: Five nursing homes in Central Catalonia (Spain).

Participants: Residents aged 65 years or older who lived in the nursing homes on a permanent basis.

Measurements: Date and causes of deaths were recorded. In addition, socio-demographic and health data were collected. For the effect of mortality, survival curves were performed using the Kaplan-Meier method and multivariate analysis using Cox regression.

Results: The total sample of 125 subjects had a mean age of 85.10 years (standard deviation=7.3). There were 59 (47.2%) deaths at 24 months (95% confidence interval [CI], 38.6-55.9) and 25 (20.0%) were due to COVID-19, mostly in the first 3 months. In multivariate analysis, functional impairment (hazard ratio [HR]: 2.40; 95% CI: 1.33-4.32) was a significant risk factor for mortality independent of age (HR: 1.17; 95% CI: 0.69-2.00) and risk of sarcopenia (HR: 1.40; 95% CI, 0.63-3.12).

Conclusions: Almost half of this sample of nursing home residents died in the 2-year period, and one fifth were attributed to COVID-19. Functional impairment was a risk factor for overall mortality and COVID-19 mortality, independent of age and risk of sarcopenia.
Original languageEnglish
Number of pages8
JournalZeitschrift für Gerontologie und Geriatrie
Early online date16 Apr 2024
DOIs
Publication statusE-pub ahead of print - 16 Apr 2024

Keywords

  • mortality
  • COVID 19
  • nursing homes
  • older adults
  • functional decline
  • predictive factors
  • pandemic
  • aged
  • survival
  • long-term care

ASJC Scopus subject areas

  • Health(social science)
  • Geriatrics and Gerontology
  • Gerontology
  • Issues, ethics and legal aspects

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