Survival prediction in nursing home residents using the Minimum Data Set subscales: ADL Self-Performance Hierarchy, Cognitive Performance and the Changes in Health, End-stage disease and Symptoms and Signs scales

TitleSurvival prediction in nursing home residents using the Minimum Data Set subscales: ADL Self-Performance Hierarchy, Cognitive Performance and the Changes in Health, End-stage disease and Symptoms and Signs scales
Publication TypeJournal Article
Year of Publication2009
AuthorsLee J.S, Chau P.P, Hui E., Chan F., Woo J.
JournalEur J Public Health
Volume19
Issue3
Pagination308-12
Date PublishedJun
ISBN Number1464-360X (Electronic)<br/>1101-1262 (Linking)
Accession Number19221020
Keywords*Activities of Daily Living, *Cognition, *Critical Illness, Age Factors, Aged, Aged, 80 and over, Female, Frail Elderly/statistics & numerical data, Geriatric Assessment, Health Status, Homes for the Aged/*statistics & numerical data, Humans, Long-Term Care/methods/statistics & numerical data, Male, Models, Biological, Nursing Homes/*statistics & numerical data, Proportional Hazards Models, Risk Factors, Sex Factors, Survival Analysis
Abstract

BACKGROUND: With the intention to aid planning for elderly focused public health and residential care needs in rapidly aging societies, a simple model using only age, gender and three Minimum Data Set (MDS) subscales (MDS-ADL Self-Performance Hierarchy, MDS-Cognitive Performance and the MDS-Changes in Health, End-stage disease and Symptoms and Signs scales) was used to estimate long-term survival of older people moving into nursing homes. METHODS: A total of 1820 nursing home residents were assessed by the MDS 2.0 and their mortality status 5 years later was used to develop a survival prediction model. RESULT: In December 2006, 54.2% of subjects were dead. Older age at nursing home admission (HR = 1.036 per 1-year increment, 95% CI 1.028-1.045), men (HR = 1.895, 95% CI 1.651-2.175), higher impairment level according to the MDS-ADL (HR = 1.135 per 1-unit increment, 95% CI 1.099-1.173) and MDS-CPS (HR = 1.077 per 1-unit increment, 95% CI 1.033-1.123), and more frail on the MDS-CHESS (HR = 1.150 per 1-unit increment, 95% CI 1.042-1.268), were all independent predictors of shorter survival after nursing home admission in multivariate analysis. Survival function was derived from the fitted Cox regression model. Survival time of nursing home residents with different combinations of risk factors were estimated through the survival function. CONCLUSION: The MDS-ADL, MDS-CPS and MDS-CHESS scales, in addition to age and gender, provide prognostic information in terms of survival time after institutionalization. The model may be useful for health care and residential care planning in an ageing community.

DOI10.1093/eurpub/ckp006
Link

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dop...https://watermark.silverchair.com/ckp006.pdf?token=AQECAHi208BE49Ooan9kk...

Short TitleEur J Public Health