Resident- and Institutional-Level Factors, Frailty, and Nursing Homes Residents

Abstract

Background: Frailty is a major cause of adverse health outcomes, such as hospitalization, falls, disability, and morbidity, among older adults; the elucidation of factors affecting frailty trends over time may facilitate the development of effective interventions.Objectives: This study aimed to examine the trend of frailty over time (at baseline, 6-month follow-up, and 12-month follow-up) among Chinese nursing home residents and identify associated resident-and institutional-level factors.Methods: This longitudinal study included 353 residents who were admitted into 27 nursing homes in Jinan, China. Frailty was defined based on the seven self-reported components of the FRAIL-NH scale, which was designed for nursing home residents. Information was gathered using scales that assessed resident-level (sociodemographic characteristics and physical, psychological, and social factors) and institutional-level characteristics (hospital affiliation, fitness sites, green space, occupancy percentage, staff-resident ratio, and staff turnover rate). These data were subjected to a multilevel linear analysis.Results: Frailty was identified in 49.7% of residents at baseline and exhibited a progressively worsening trend over 1 year. Among institutional-level characteristics, the provision of fitness sites in nursing homes was a protective factor for frailty. Among resident-level characteristics, undernutrition was a significant independent risk factor and played a key role in increasing frailty over time. Other risk factors for frailty included younger age, poorer self-rated health, lower physical function, chewing difficulty, loneliness, anxiety, and being less active in leisure activities.Discussion: Frailty was highly prevalent among Chinese nursing home residents and gradually increased over time. The results of this study could be used to inform the development of interventions targeted at modifiable risk factors and shape public health policies aimed at promoting healthy aging and delaying frailty and its adverse outcomes.

Chewing difficulty and frailty trajectories in Chinese nursing home residents: A prospective cohort study

“…This is a 1‐year prospective cohort study. The method of and participants' recruitment and follow‐up has been described previously 9 . Briefly, 27 nursing homes with ≥30 beds that had operated for longer than 1 year were included in this study.…”

“…The method of and participants' recruitment and follow-up has been described previously. 9 Briefly, 27 nursing homes with ≥30 beds that had operated for longer than 1 year were included in this study. Older adults aged ≥60 years who lived in nursing homes for at least 3 months were deemed eligible.…”

“…However, presently, few studies have investigated the longitudinal experience of frailty among nursing home residents, and most were population-based studies. [7][8][9] Such studies provide valuable information about the overall trend or the change in prevalence of frailty over time but do not differentiate the variation between intra-and interindividual. Community studies revealed that varying frailty trajectories existed in older people.…”