Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
J Am Med Dir Assoc. 2022 Nov;23(11):1815-1825.e9. doi: 10.1016/j.jamda.2022.05.001. Epub 2022 Jun 6.
To review the evidence on incidence and predictive factors of functional decline (FD) in nursing home (NH) residents.
A systematic review of the literature.
Longitudinal studies involving individuals age 60 years and older living in a NH and with at least 2 functional capacity assessments were eligible.
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.
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.
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.
综述养老院居民发生功能下降（FD）的情况及相关预测因素的证据。
文献系统综述。
纳入标准为年龄≥60 岁、居住在养老院、至少进行过 2 次功能能力评估的个体的纵向研究。
检索截至 2021 年 6 月，在 Embase、PubMed、Web of Science、Cochrane 图书馆、CINAHL、Scopus、SciELO 和 Google Scholar 数据库中进行检索。
共有 27 项研究符合纳入标准，其中大多数为前瞻性研究，在多个养老院招募参与者，并在单一国家进行。研究报告了基线时较高的功能依赖率和随访时的 FD 发生率；在 1 年内，38.9%至 50.6%的居民经历了 FD。在至少 2 项纳入研究中具有显著意义的 FD 预测因素包括认知障碍、基线时的功能状态、尿失禁、机构入住时间、年龄、抑郁、已婚、男性和中风疾病。保护因素包括注册护士工作时间和养老院工作人员中是否有老年病医生。
本综述强调了养老院居民 FD 的高发生率，并确定了 FD 的风险和保护因素，这可能为这一脆弱和脆弱人群设计预防策略提供支持。
