Infections and functional impairment in nursing home residents: a reciprocal relationship.

Détails

ID Serval
serval:BIB_198D57186B77
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Infections and functional impairment in nursing home residents: a reciprocal relationship.
Périodique
Journal of the American Geriatrics Society
Auteur(s)
Büla C.J., Ghilardi G., Wietlisbach V., Petignat C., Francioli P.
ISSN
0002-8614
Statut éditorial
Publié
Date de publication
2004
Peer-reviewed
Oui
Volume
52
Numéro
5
Pages
700-6
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article - Publication Status: ppublish
Résumé
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.
Mots-clé
Activities of Daily Living, Aged, Aged, 80 and over, Cohort Studies, Data Interpretation, Statistical, Disabled Persons, Female, Follow-Up Studies, Geriatric Assessment, Health Status, Humans, Immunization, Infection, Male, Nursing Homes, Odds Ratio, Proportional Hazards Models, Prospective Studies, Quality of Life, Respiratory Tract Infections, Risk, Risk Factors, Survival Analysis, Time Factors, Urinary Tract Infections
Pubmed
Web of science
Création de la notice
05/03/2008 16:57
Dernière modification de la notice
20/08/2019 13:50
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