Predictors of mortality in nursing home residents: a 2-year prospective longitudinal study.

Abstract

Background The age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and to mortality in general. For this reason, our objective is to verify the incidence of general and COVID-19 mortality and to analyse its predictive factors in older people living in nursing homes over a 2-year period. Methods A two-year prospective longitudinal multicenter study was carried out in 5 nursing homes in Central Catalonia (Spain) between 2020 and 2022. Date and causes of deaths were recorded. In addition, sociodemographic 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). A total of 59 (47.2%) deaths were recorded at 24 months (95% confidence interval [CI], 38.6–55.9) and 25 (20.0%) were due to COVID-19 most in first 3 months. In the multivariate analysis, functional impairment (hazard ratio [HR]: 2.40, 95% CI: 1.33–4.32, p = 0.003) was a significant risk factor for mortality independently of age (HR: 1.17, 95% CI: 0.69-2.00, p = 0.549) and risk of sarcopenia (HR: 1.40, 95% CI, 0.63–3.12, p = 0.403). Conclusions Nearly half of this sample of nursing home residents died within the 2-year period, and 20% 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.