Unhealthy lifestyle factors associated with increased risk nursing home admission

Key takeaways:

• .An unhealthy lifestyle was associated with a “marked increased risk” of admission to a nursing home
• Researchers said evidence could be a “powerful motivator” for healthier lifestyle changes.

Smoking, sedentary behavior and physical inactivity were among lifestyle factors linked to increased risk nursing home admissions, a recent study found.

According to Alice A. Gibson, BSc, APD, PhD, a research fellow at the University of Sydney in Australia, and colleagues, there is substantial evidence that lifestyle-related risk factors “are associated with the development and progression of multiple common debilitating chronic diseases such as cardiovascular disease, stroke, chronic nephropathy, cancer, dementia and frailty.”

“However, very little is known about how lifestyle risk factors impact on long-term nursing home placement,” they wrote in the Journal of Epidemiology and Community Health.

So, the researchers aimed to fill gaps in literature by analyzing data 127,108 participants aged 60 years or older from an Australian prospective cohort study.

Patients were divided into three riskgroups based on five lifestyle categories: smoking status, diet quality, physical activity, sleep duration and sedentary behavior.

Among the patients, 25% were in the low-risk, or healthiest, lifestyle group. The unhealthiest, high-risk group comprised 14% of the sample, 62% made up the medium-risk group.

Overall, the risk for nursing home admission was 43% (adjusted HR = 1.43; 95% CI, 1.36-1.5) and 12% (aHR = 1.12; 95%CI, 1.08-1.16) greater for those in the high- and medium-risk groups, respectively, compared those in the low-risk group.

In the high-risk group, participants aged 60 to 64 years had the highest risk admission (aHR = 2.15; 95%CI, 1.82-2.54).
the low-risk group, the mutually aHR for admission among those in the high-risk group was:

• 1.55 (95% CI, 1.45-1.66) for smoking;
• 1.29 (95% CI, 1.22-1.38) for sleep duration;
• 1.19 (95% CI, 1.16-1.23) for physical activity; and
• 1.12 (95% CI, 1.07-1.17) for sedentary behavior.

Diet quality was the only lifestyle factor that did not have any risk associations.

Ultimately, “these findings highlight that lifestyle factors are important in relatively younger age group of 6064 years and have less of an impact on nursing home admission in older age groups where other comorbidities may be driving nursing home admissions,” the researchers wrote.

Evidence that healthy lifestyle habits may reduce the risk for nursing home admission “could be a powerful motivator for many individuals to adopt or maintain a healthier lifestyle”

“Furthermore, our findings may also incentivize government investment in preventative health care and health promotion given the greater cost associated with caring for people in institutions,” Gibson and colleagues wrote. “This will require a shift in health policy towards preventative health.”

References:

• Gibson A, et al. J Epidemiol Community Health. 2023;doi:10.1136/jech-2023-220518.
• Poor lifestyle of over 60s linked to heightened risk of nursing home care. https://www.eurekalert.org/news-releases/999209. Published Aug. 24, 2023. Accessed Aug. 24, 2023.