Incidence and predictive factors of functional decline in older people living in nursing homes: a systematic review

Pau Moreno-Martin, Javier Jerez Roig*, Sandra Rierola-Fochs, Vinicius Rosa Oliveira, Pau Farres-Godayol, Dyego Leandro Bezerra de Souza , Maria Gine-Garriga, Jo Booth, Dawn Skelton, Eduard Minobes-Molina

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives
To review the evidence on incidence and predictive factors of functional decline (FD) in nursing home (NH) residents.
Design
A systematic review of the literature.
Setting and Participants
Longitudinal studies involving individuals age 60 years and older living in a NH and with at least 2 functional capacity assessments were eligible.
Methods
The search was carried out up to June 2021 and was conducted in Embase, PubMed, Web of Science, Cochrane Library, CINAHL, Scopus, SciELO, and Google Scholar databases.
Results
A total of 27 studies met the eligibility criteria, most of which were prospective, recruiting participants in more than 1 NH, and conducted in a single country. Studies reported a high rate of functional dependency at baseline and FD at follow-up; in 1 year, 38.9% to 50.6% of residents experienced FD. Predictive factors of FD that were significant in at least 2 of the included studies were cognitive impairment, functional status at baseline, urinary incontinence, length of institutionalization, age, depression, being married, being male, and stroke disease. Protective factors were licensed nursing hours and presence of a geriatrician within the NH staff.
Conclusions and Implications
This review highlights the high incidence of FD in NH residents and identifies risk and protective factors of FD that may support the design of preventative strategies for this vulnerable and frail population.
Original languageEnglish
JournalJAMDA: The Journal of Post-Acute and Long-Term Care Medicine
Early online date6 Jun 2022
DOIs
Publication statusE-pub ahead of print - 6 Jun 2022

Keywords

  • activities of daily living
  • functional decline
  • ADLs
  • care homes
  • nursing homes
  • incidence
  • older adults
  • systematic review
  • aged
  • older people

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Nursing(all)
  • Geriatrics and Gerontology
  • Health Policy

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