Assessment of risk factors associated with long-term mortality in nursing homes: result from the SENIOR cohort

Background Previous studies on risk factors for death in nursing homes have focused on short-term observation and limited number risk factors. Aims This study aims to identify factors predictive of 8-year survival in nursing homes. Methods The study used the baseline measurements from the SENIOR cohort collected in 2013–2014. Data included clinical assessments (i.e., body composition, nutritional status, physical performance, level of dependence and cognition, frailty phenotype) as well as demographic information, number of medications and medical history. Mortality data were collected annually for 8 years. Univariate analyses were initially performed to assess potential predictive factors, followed by a Cox regression model using stepwise selection. Results Of the 662 participants enrolled in the cohort, 58 (8.8%) were not further assessed due to the withdrawal of 2 nursing homes and 71 (10.7%) had no mortality data available (i.e., relocation, refusal to continue the study). Among the 533 patients included, 111 (20.8%) were still alive in 2022. Median survival time was 4 years (1.93–6.94). Multivariate regression showed that younger age (HR = 1.04 (1.03–1.06)), higher body mass index (HR = 0.96 (0.94–0.98)), higher score on the Mini-Mental State-Examination (HR = 0.97 (0.94–0.99)) and higher score on the Short Physical Performance Battery (HR = 0.93 (0.90–0.97)) were protective factors against mortality. Conclusions This study highlights that certain modifiable factors related to physical or mental health contribute to increased survival in nursing homes. Because of its ability to improve physical performance and partly cognitive function, promoting physical activity in nursing homes appears to be a public health priority.