Impact of lifestyle risk factors on admission to nursing home care

A cohort study of 127 108 people aged 60 years and over

Bibliographic Data

ID11171981
AuthorsAlice A Gibson (0000-0001-8750-9720, The University of Sydney, corresponding author), Joanne Gale (The University of Sydney), Emmanuel Stamatakis (0000-0001-7323-3225, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia), Richard I Lindley (0000-0002-0104-5679, The University of Sydney), Luigi Fontana (0000-0001-8500-5537, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia), Peter A Cistulli (0000-0002-7920-4924, Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia), Natasha Nassar (0000-0002-3720-9655, The University of Sydney)
Year2023
Volume77
Issue11
Pages744-751
Publication date2023-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Epidemiology and Community Health (JOURNAL)
Journal identifiersISSN: 0143-005X • E-ISSN: 1470-2738
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jech-2023-220518
PMID37620005
OpenAlexW4386125545
LanguageEN
Citations received1
References cited28

BACKGROUND: Little is known on how lifestyle factors, individually or in combination, may relate to nursing home admission, an outcome of great societal and economic importance with increased population ageing. The aim of this study was to determine the association of lifestyle risk factors with nursing home admission. METHODS: This prospective cohort study linked data from the 45 and Up Study, Australia, to health records. 127 108 men and women, aged ≥60 years, were recruited between 2006 and 2009. A healthy lifestyle score categorised participants into three risk groups based on five equally contributing risk factors: smoking status, physical activity, sedentary behaviour, sleep duration and diet quality. HRs for incident nursing home admission were estimated using multivariable Cox proportional hazards model. RESULTS: One-quarter of participants were in the low-risk lifestyle group, 62% were in the medium-risk group and 14% in the high-risk (least healthy) group. During a median (IQR) follow-up of 11.3 years, 23 094 (18%) participants were admitted to a nursing home. Compared with those in the low-risk group, risk of nursing home admission was 43% higher among participants in the high-risk group (multivariable adjusted HR (aHR) 1.43; 95% CI 1.36 to 1.50); and participants in the medium-risk group had an intermediate 12% greater risk (aHR 1.12; 95% CI 1.08 to 1.16). Participants aged 60-64 years in the high-risk (aHR 2.15; 95% CI 1.82 to 2.54) lifestyle group had the greatest risk of nursing home admission. CONCLUSION: An unhealthy lifestyle was associated with a marked increased risk of admission to a nursing home in adults aged 60+ years. Interventions focused on lifestyle modifications may prevent or delay nursing home admission

Cohort · Cohort study · Environmental health · Physical therapy · Population · Proportional hazards model · Prospective cohort study · Frailty in Older Adults · Geriatric Care and Nursing Homes · Intergenerational Family Dynamics and Caregiving · Internal Medicine · Medicine · Gerontology