title: Differences in predictors of 5-year survival over a 10-year period in two cohorts of elderly nursing home residents in Sweden.
abstract: OBJECTIVE
  The aim was to compare 5-year survival in two included cohorts (from year 2000 and year 2007) of 249 nursing home residents (NHR) in this retrospective, comparative study.
  
  
  METHODS
  The cohorts were compared regarding chronic diseases, medication, physical/cognitive/nutritional status, body mass index, body temperature and 5-year mortality. Factors correlated with 5-year survival were determined using Cox regression analysis.
  
  
  RESULTS
  In average, cohort 2007 survived 31 ± 16 months and cohort 2000, 38 ± 13 months, p < 0.001. Dementia, ageing and circulatory failure were more common as cause of death 2007, while stroke, chronic obstructive pulmonary disease (COPD) and pneumonia were less common, compared with 2000. NHR belonging to cohort 2007 were significantly older when admitted to nursing homes (NH), more dependent in activities of daily living (ADL), had dementia, stroke, autoimmune disease and treatment with antidepressants, while malnutrition and treatment with paracetamol were more common 2000. In 2000, medication with antidepressants, the presence of stroke and diabetes, irrespective of gender, and in women cardiovascular disease, two to threefold significantly increased survival, while autoimmune disease, influenza vaccination and dependency in ADL decreased survival. In 2007, maintaining BMI, irrespective of gender, and autoimmune disease and COPD in women significantly increased survival, while malnutrition, influenza vaccination, dependency in ADL and medication with sedatives/tranquillisers or paracetamol severely reduced survival.
  
  
  CONCLUSIONS
  The present results indicate a trend that individuals are older and frailer when admitted to NH and that survival time after admission has been shortened. Hence, the need of daily support and care has increased, irrespective of housing. Also, predictors of survival, possible to influence, have changed.
authors: Department of Nursing, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors: Märta
authors: M
authors: Sund Levander
authors: Department of Social and Welfare Studies, Palliative Education & Research Centre, and Faculty of Medicine, Linköping University, Norrköping, Sweden.
authors: Anna
authors: A
authors: Milberg
authors: Department of Public Health and Caring Sciences, Faculty of Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
authors: Nils
authors: N
authors: Rodhe
authors: Department of Nursing, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors: Pia
authors: P
authors: Tingström
authors: Department Forensic Genetics and Forensic Toxicology, Faculty of Medicine, Linköping University, Linköping, Sweden.|Department of Pharmaceutical Research, Faculty of Medicine, Linköping University, Linköping, Sweden.
authors: Ewa
authors: E
authors: Grodzinsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007297:Inpatients; D009735:Nursing Homes; D016016:Proportional Hazards Models; D016019:Survival Analysis; D013548:Sweden
keywords: frail elderly; gender; survival