title: Health-related quality of life, rehabilitation and mortality in a nursing home population.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) in nursing home residents is generally low. The purpose of this study was to investigate the associations between HRQOL and two clinically relevant outcome measures, all-cause mortality and successful rehabilitation, in a nursing home population.
  
  
  METHODS
  In an observational prospective cohort study in a nursing home population, HRQOL was assessed with the RAND-36. A total of 184 patients were included, 159 (86%) completed the RAND-36 and were included in the study. A Cox proportional hazard model was used to investigate the independent association between HRQOL, rehabilitation and mortality with adjustment for confounders. Risk prediction capabilities were assessed with Harrell's C statistics and the proportion of explained variance (R2).
  
  
  RESULTS
  The median age (interquartile range) was 79 (75-85) years. The health dimensions vitality (HR 0.88 (95% CI 0.77-0.99)) and mental health (HR 0.86 (95% CI 0.75-0.98)) were inversely associated and role functioningphysical (HR 1.08 (95%CI 1.02-1.15)) was positively associated with mortality. The Harrell's C value and the R2 were ≤ 0.02 and ≤ 0.03 higher in the adjusted models with the dimensions role functioning- physical, mental health or vitality compared with the models without these dimensions. None of the health dimensions or summary scales were related to successful rehabilitation.
  
  
  CONCLUSIONS
  HRQOL was significantly associated with mortality for three dimensions, but partly in opposite directions. Additional value of HRQOL in mortality prediction is very limited. There were no independent associations between HRQOL and successful rehabilitation. Although HRQOL is an important outcome, this study did not provide evidence for an association between HRQOL and successful rehabilitation.
authors: Diabetes Centre, Isala, Zwolle, the Netherlands.
authors: L C
authors: LC
authors: Hartog
authors: G W D
authors: GW
authors: Landman
authors: M
authors: M
authors: Cimzar-Sweelssen
authors: A
authors: A
authors: Knipscheer
authors: K H
authors: KH
authors: Groenier
authors: N
authors: N
authors: Kleefstra
authors: H J G
authors: HJ
authors: Bilo
authors: K J J
authors: KJ
authors: van Hateren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009026:Mortality; D009426:Netherlands; D009735:Nursing Homes; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012046:Rehabilitation