Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Infections and Functional Impairment in Nursing Home Residents: A Reciprocal Relationship

Infections and Functional Impairment in Nursing Home Residents: A Reciprocal Relationship Objectives: To determine the relationship between infections and functional impairment in nursing home residents. Design: Prospective cohort study (follow‐up period, 6 months). Setting: Thirty‐nine nursing homes in western Switzerland. Participants: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent. Measurements: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow‐up and (b) functional status score using a standardized measure. Results: At the end of follow‐up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P=.11). During both 3‐month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.2–2.2, P=.002, and AOR=1.5, 95% CI=1.1–2.0, P=.008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline. Conclusion: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of American Geriatrics Society Wiley

Infections and Functional Impairment in Nursing Home Residents: A Reciprocal Relationship

Loading next page...
 
/lp/wiley/infections-and-functional-impairment-in-nursing-home-residents-a-EVX0zJpp82

References (30)

Publisher
Wiley
Copyright
Copyright © 2004 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0002-8614
eISSN
1532-5415
DOI
10.1111/j.1532-5415.2004.52205.x
pmid
15086648
Publisher site
See Article on Publisher Site

Abstract

Objectives: To determine the relationship between infections and functional impairment in nursing home residents. Design: Prospective cohort study (follow‐up period, 6 months). Setting: Thirty‐nine nursing homes in western Switzerland. Participants: A total of 1,324 residents aged 65 and older (mean age 85.7; 76.6% female) who agreed to participate, or their proxies, by oral informed consent. Measurements: Functional status measured every 3 months. Two different outcomes were used: (a) functional decline defined as death or decreased function at follow‐up and (b) functional status score using a standardized measure. Results: At the end of follow‐up, mortality was 14.6%, not different for those with and without infection (16.2% vs 13.1%, P=.11). During both 3‐month periods, subjects with infection had higher odds of functional decline, even after adjustment for baseline characteristics and occurrence of a new illness (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.2–2.2, P=.002, and AOR=1.5, 95% CI=1.1–2.0, P=.008, respectively). The odds of decline increased in a stepwise fashion in patients with zero, one, and two or more infections. The analyses predicting functional status score (restricted to subjects who survived) gave similar results. A survival analysis predicting time to first infection confirmed a stepwise greater likelihood of infection in subjects with moderate and severe impairment at baseline than in subjects with no or mild functional impairment at baseline. Conclusion: Infections appear to be both a cause and a consequence of functional impairment in nursing home residents. Further studies should be undertaken to investigate whether effective infection control programs can also contribute to preventing functional decline, an important component of these residents' quality of life.

Journal

Journal of American Geriatrics SocietyWiley

Published: May 1, 2004

There are no references for this article.