Rational prescribing in geriatrics represents an important ethical as well as socio-economic issue. The aim of this project was to analyze the drug-related problems (DRPs) among the Czech nursing home residents and increase public awareness of further possible employment of clinical pharmacists in social care. The project was designed as a multicenter observational study. A total of 16 nursing homes and 800 participants with an average age of 84.6 ± 7.3 years were included in the study. Of them, a DRP was noted in 93.3% of people. The total amount of DRPs identified was 2215, which means an average of 2.8 ± 1.6 DRPs per patient. The most common DRPs identified were 'overtreatment' (19.5%), 'undertreatment' (12.8%), inappropriate dose (10.6%), recommendations for laboratory monitoring (10.4%) and adverse effects (10.3%). Of different drug classes, BZDs (OR 16.6, 95% CI 1.0-270.2), PPIs (OR 2.5, 95% CI 1.1-5.6) and NSAIDs (OR 4.4, 95% CI 1.1-18.3) were identified to be most commonly associated with DRPs. The risk of DRP identification clearly increased with the number of drugs used, with seven drugs demonstrated as the best cut-off for predicting DRP identification (AUC 0.842, sensitivity 0.602; specificity 0.796). 'SENIOR' project has confirmed a high rate of excessive polypharmacy among nursing home residents in the Czech republic resulting in high risk of potential and manifested DRPs. The project emphasized the role of clinical pharmacists in optimizing safety and effectiveness of treatment among older nursing home residents.

• MeSH
• Homes for the Aged * statistics & numerical data   MeSH
• Pharmacists MeSH
• Pharmaceutical Services * organization & administration   MeSH
• Humans MeSH
• Inappropriate Prescribing * statistics & numerical data   prevention & control   MeSH
• Drug-Related Side Effects and Adverse Reactions * epidemiology   diagnosis   prevention & control   MeSH
• Nursing Homes * statistics & numerical data   MeSH
• Polypharmacy MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Geographicals
• Czech Republic MeSH

INTRODUCTION: Previous research has raised concerns about high prevalence of drug-related problems, polypharmacy and inappropriate benzodiazepine prescribing in nursing homes (NHs) and confirmed lack of studies from Central and South-Eastern Europe. The aim of our study was to determine the prevalence and characteristics of polypharmacy, hyperpolypharmacy and inappropriate benzodiazepine prescribing in NH residents in Croatia. METHODS: Data from 226 older NH residents from five Croatian NHs were collected using the InterRAI Long-Term Care Facilities assessment form. The prevalence and determinants of polypharmacy/hyperpolypharmacy and patterns of inappropriate benzodiazepine prescribing were documented. RESULTS: The prevalence of polypharmacy (49.6%) and hyperpolypharmacy (25.7%) among NH residents was high. In our study, 72.1% of NH residents were prescribed at least one psychotropic agent, 36.7% used 2-3 psychotropics and 6.6% used 4+ psychotropics. Among benzodiazepine users (55.8%), 28% of residents were prescribed benzodiazepines in higher than recommended geriatric doses, 75% used them for the long term and 48% were prescribed concomitant interacting medications. The odds of being prescribed polypharmacy/hyperpolypharmacy were significantly higher for older patients with polymorbidity (6+ disorders, proportional odds ratio (POR) = 19.8), type II diabetes (POR = 5.2), ischemic heart disease (POR = 4.6), higher frailty (Clinical Frailty Scale (CFS ≥5); POR = 4.3) and gastrointestinal problems (POR = 4.8). CONCLUSIONS: Our research underscores the persistent challenge of inappropriate medication use and drug-related harms among older NH residents, despite existing evidence and professional campaigns. Effective regulatory and policy interventions, including the implementation of geriatrician and clinical pharmacy services, are essential to address this critical issue and ensure optimal medication management for vulnerable NH populations.

• MeSH
• Benzodiazepines * therapeutic use   adverse effects   administration & dosage   MeSH
• Homes for the Aged statistics & numerical data   MeSH
• Practice Patterns, Physicians' statistics & numerical data   standards   MeSH
• Humans MeSH
• Inappropriate Prescribing * statistics & numerical data   MeSH
• Nursing Homes * statistics & numerical data   MeSH
• Polypharmacy * MeSH
• Prevalence MeSH
• Psychotropic Drugs therapeutic use   adverse effects   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Croatia MeSH

BACKGROUND: Proximal femoral fractures are severe injuries in geriatric patients. Additionally, geriatric patients are at a high risk of death due to coronavirus disease 2019 (COVID-19). OBJECTIVE: To identify predictors of mortality in geriatric patients with COVID-19 and concurrent proximal femoral fractures. MATERIAL AND METHODS: Patients who underwent surgical treatment for proximal femoral fractures and also tested positive for COVID-19 were included. The age, gender, the American Society of Anesthesiology (ASA) score and the admission from a nursing home were considered as variables. The rate of reoperations, the mortality at 3 months and discharge home were evaluated as outcomes. RESULTS: In this study 46 patients with COVID-19 (female/male 31/15, median age 87.0 years with an interquartile range [IQR] of 9.8 years) met the inclusion criteria. Of these, 32 patients (69.6%) had to be cared for in the intensive care unit and 26 patients (56.5%) had a severe course of COVID-19 with pneumonia. The median length of hospital stay for survivors was 19 (IQR 17.5) days and 4 of the patients (8.7%) required surgical revision. The in-hospital and 3‐month mortality were 40.0% (n = 17) and 43.5% (n = 20), respectively. The factors which influenced the in-hospital and 3‐month mortality rates were admission from a nursing home, the presence of pneumonia (increased the risk of death) and female gender (protective). CONCLUSION: The occurrence of COVID-19 in patients with proximal femoral fractures has a high mortality. Admission from a nursing home and the presence of pneumonia increased the risk of death, whereas women were at lower risk.

• MeSH
• COVID-19 * mortality   MeSH
• Length of Stay statistics & numerical data   MeSH
• Femoral Fractures mortality   surgery   MeSH
• Hip Fractures mortality   surgery   MeSH
• Proximal Femoral Fractures MeSH
• Humans MeSH
• Hospital Mortality MeSH
• Nursing Homes * statistics & numerical data   MeSH
• Reoperation statistics & numerical data   MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• SARS-CoV-2 MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Germany MeSH

IMPORTANCE: Evacuation has been found to be associated with adverse outcomes among nursing home residents during hurricanes, but the outcomes for assisted living (AL) residents remain unknown. OBJECTIVE: To examine the association between evacuation and health care outcomes (ie, emergency department visits, hospitalizations, mortality, and nursing home visits) among Florida AL residents exposed to Hurricane Irma. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using 2017 Medicare claims data. Participants were a cohort of Florida AL residents who were aged 65 years or older, enrolled in Medicare fee-for-service, and resided in 9-digit zip codes corresponding to US assisted living communities with 25 or more beds on September 10, 2017, the day of Hurricane Irma's landfall. Propensity score matching was used to match evacuated residents to those that sheltered-in-place based on resident and AL characteristics. Data were analyzed from September 2022 to February 2024. EXPOSURE: Whether the AL community evacuated or sheltered-in-place before Hurricane Irma made landfall. MAIN OUTCOMES AND MEASURES: Thirty- and 90-day emergency department visits, hospitalizations, mortality, and nursing home admissions. RESULTS: The study cohort included 25 130 Florida AL residents (mean [SD] age 81 [9] years); 3402 (13.5%) evacuated and 21 728 (86.5%) did not evacuate. The evacuated group had 2223 women (65.3%), and the group that sheltered-in-place had 14 556 women (67.0%). In the evacuated group, 42 residents (1.2%) were Black, 93 (2.7%) were Hispanic, and 3225 (94.8%) were White. In the group that sheltered in place, 490 residents (2.3%) were Black, 707 (3.3%) were Hispanic, and 20 212 (93.0%) were White. After 1:4 propensity score matching, when compared with sheltering-in-place, evacuation was associated with a 16% greater odds of emergency department visits (adjusted odds ratio [AOR], 1.16; 95% CI, 1.01-1.33; P = .04) and 51% greater odds of nursing home visits (AOR, 1.51; 95% CI, 1.14-2.00; P = .01) within 30 days of Hurricane Irma's landfall. Hospitalization and mortality did not vary significantly by evacuation status within 30 or 90 days after the landfall date. CONCLUSIONS AND RELEVANCE: In this cohort study of Florida AL residents, there was an increased risk of nursing home and emergency department visits within 30 days of Hurricane Irma's landfall among residents from communities that evacuated before the storm when compared with residents from communities that sheltered-in-place. The stress and disruption caused by evacuation may yield poorer immediate health outcomes after a major storm for AL residents. Therefore, the potential benefits and harms of evacuating vs sheltering-in-place must be carefully considered when developing emergency planning and response.

• MeSH
• Cyclonic Storms * statistics & numerical data   MeSH
• Assisted Living Facilities * statistics & numerical data   MeSH
• Hospitalization statistics & numerical data   MeSH
• Humans MeSH
• Medicare statistics & numerical data   MeSH
• Nursing Homes statistics & numerical data   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Emergency Service, Hospital statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH
• Geographicals
• Florida MeSH
• United States MeSH

OBJECTIVE: To prevent osteoporotic fractures in nursing home residents a combination of bisphosphonates, calcium and vitamin D is recommended. This study assessed the prevalence of pharmacological osteoporosis prevention in nursing home residents from eight countries, and assessed its association with patient characteristics. DESIGN: Cross-sectional analyses of the SHELTER study data. We assessed the overall prevalence of osteoporosis medication (OM) use (vitamin D, calcium and bisphosphonates) in residents stratified for falls and fractures over last 30 days, health instability with high mortality risk, cognitive impairment, and dependence in walking. SETTING AND PARTICIPANTS: Nursing home residents in the Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel. RESULTS: Of 3832 eligible residents, vitamin D, calcium and bisphosphonates were used by 16.2%, 10.4%, and 4.5% respectively. All 3 classes of OM together were used by 1.5% of all residents. Of residents with a recent fracture, 9.5% used a bisphosphonate (2.7% all 3 OMs). In patients with recent falls, 20.8% used vitamin D and 15.3% calcium. In residents with severe cognitive impairment, 15.5% used vitamin D and 9.3% used calcium. Of the bisphosphonate users, 33.7% also used both vitamin D and calcium, 25.8% used only calcium in addition and 17.4% only vitamin D in addition. The use of any OM varied widely across countries, from 66.8% in Finland to 3.0% in Israel. CONCLUSIONS AND IMPLICATIONS: We found substantial pharmacological under-treatment of prevention of osteoporosis in residents with recent falls, fractures and dependence in walking. Only two-thirds of bisphosphonate users also took a vitamin D-calcium combination, despite guideline recommendations. On the other hand, possible over-treatment was found in residents with high mortality risk in whom preventive pharmacotherapy might not have still been appropriate. The prevalence of pharmacological prevention of osteoporosis differed substantially between countries. Efforts are needed to improve pharmacotherapy in residents.

• MeSH
• Diphosphonates therapeutic use   MeSH
• Humans MeSH
• Osteoporotic Fractures prevention & control   MeSH
• Osteoporosis drug therapy   prevention & control   MeSH
• Nursing Homes statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Drug Utilization statistics & numerical data   MeSH
• Accidental Falls MeSH
• Calcium, Dietary therapeutic use   MeSH
• Vitamin D therapeutic use   MeSH
• Vitamins therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH
• Geographicals
• Europe MeSH
• Israel MeSH

AIMS: To describe the associations between dysphagia and malnutrition risk and to identify predictors for dysphagia in a group of persons at risk of malnutrition in hospitals and nursing homes. DESIGN: A secondary analysis of cross-sectional data from the years 2012-2016. METHODS: The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool for Adults (MUST). The data were compared regarding malnutrition risk and dysphagia. Regression analyses were conducted to identify variables that were associated with the risk of malnutrition and dysphagia. RESULTS: Patients (N = 17,580) were included in the study sample. The prevalence of dysphagia was 6.6% and the prevalence of malnutrition risk was 18.9%. A multivariable logistic regression analysis resulted in the identification of dysphagia and cancer as variables with the highest odds ratios with regard to malnutrition risk. Patients with cancer, stroke or respiratory diseases represent a high-risk group for the co-occurrence of dysphagia and risk of malnutrition. CONCLUSIONS: Screening for dysphagia should be carried out on patients at risk of malnutrition as an integral part of their admission to a healthcare institution and especially on the higher risk group of patients with cancer, a stroke or a respiratory disease. IMPACT: What problem did the study address? This study identified the relationship between dysphagia and malnutrition risk and associated factors. What were the main findings? Dysphagia among patients in the research sample was associated with more than two times higher prevalence of the malnutrition risk. Where and on whom will the research have an impact? Thorough malnutrition risk and dysphagia screening lead to better nursing care.

• MeSH
• Stroke epidemiology   MeSH
• Comorbidity MeSH
• Middle Aged MeSH
• Humans MeSH
• Logistic Models MeSH
• Neoplasms epidemiology   MeSH
• Respiratory Tract Diseases epidemiology   MeSH
• Hospitals statistics & numerical data   MeSH
• Nursing Homes statistics & numerical data   MeSH
• Malnutrition epidemiology   MeSH
• Deglutition Disorders epidemiology   MeSH
• Cross-Sectional Studies MeSH
• Surveys and Questionnaires MeSH
• Risk Factors MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

Úvod: Současným trendem je podpora setrvání seniorů v jejich domácím prostředí ve stavu nemoci či snížené soběstačnosti. Tuto skutečnost podporují jak mezinárodní, tak i národní strategické dokumenty, které si ve svých doporučeních kladou za cíl snížit počet hospitalizací u seniorů a péči o seniory přesunout do jejich domácího prostředí. Metody: Pro analýzu vývoje počtu pacientů v domácí zdravotní péči, hospitalizovaných pacientů a klientů pobytových zařízení sociálních služeb byly dány do souvislostí dostupné statistické údaje a přehledy. Výsledek: Mezi roky 2000 a 2016 stoupl počet obyvatel starších 65 let, stejně tak stoupl i počet pacientů domácí zdravotní péče starších 65 let (o 8,68 %), nicméně procento pacientů této věkové kategorie ošetřených v rámci domácí zdravotní péče vzhledem ke stejně staré populaci a počtu pacientů ošetřených v instituci kleslo ze 7,52 % v roce 2000 na 5,84 % v roce 2016. Mezi roky 2000 a 2016 vzrostl počet hospitalizací u pacientů starších 65 let o 30,66 %. Rovněž v tomto období vzrostl počet pacientů přeložených do pobytových zařízení sociálních služeb. Vývoj počtu klientů v pobytových zařízeních sociálních služeb měl výrazně vzestupný charakter. V těchto zařízeních došlo v období let 2006 až 2016 k 15% nárůstu počtu klientů. Počet neuspokojených žádostí o pobyt v zařízeních sociálních služeb zaznamenal v tomto období také stoupající tendenci, a to zejména v případě pobytové služby "domov se zvláštním režimem", kde došlo k 171% nárůstu počtu neuspokojených žádostí. Závěr: I přes cíle strategických dokumentů nedošlo v posledních letech k nárůstu počtu pacientů starších 65 let v domácí zdravotní péči vzhledem k pacientům z řad stejně staré populace. Naopak došlo k výraznému nárůstu počtu hospitalizací u pacientů starších 65 let a zároveň došlo k rychlému nárůstu počtu klientů pobytových zařízení sociálních služeb, včetně neuspokojených žádostí o tyto služby.

Purpose: The current trend is to support seniors staying in their homes in a state of illness or reduced self-sufficiency. This fact is supported by both international and national strategy papers, which aim to reduce the number of hospitalizations in older adults and move the care for the elderly in to their homes. Methods: Available statistics and overviews were put into the context for the analysis of the development of the number of home health care patients, hospitalized patients and clients of the residential care facilities. Results: The number of people aged 65 and older, as well as the number of home health care patients aged 65 and older (by 8.68%) grew between 2000 and 2016, however the percentage of home health care patients of this age group decreased in the context of the same old population from 7.52% in 2000 to 5.84% in 2016. The number of hospitalizations in patients aged 65 years and older increased by 30.6% between 2000 and 2016. Likewise, the number of patients transferred from hospitals to residential care facilities increased during this period. The number of clients in residential care facilities was rising significantly. In these facilities, the number of clients increased by 15% between 2006 and 2016. The number of unsatisfied applications for residential care facilities grew during this period as well, especially in the case of residential service "residential care facility for people with dementia", where the number of unsatisfied applications increased by 171%. Conclusion: In spite of the strategic documents objectives, the number of home health care patients aged 65 and older has not grown in recent years considering the same old population. Instead, there has been a significant increase in the number of hospitalizations in patients aged 65 years and older and there has been a rapid increase in the number of clients of residential care facilities as well, including unsatisfied applications for these services.

• MeSH
• Hospitalization statistics & numerical data   MeSH
• Humans MeSH
• Nursing Homes statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

OBJECTIVE: The care processes directed towards institutionalized older people needs to be tailored on goals and priorities that are relevant for this specific population. The aim of the present study was (a) to describe the distribution of selected health determinants in a sample of institutionalized older adults, and (b) to investigate the impact on survival of such measures. DESIGN: Multicentre longitudinal cohort-study. SETTING: 57 nursing homes (NH) in 7EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non-EU country (Israel). PARTICIPANTS: 3036 NH residents participating in the Services and Health for Elderly in Long TERm care (SHELTER) study. MEASUREMENTS: We described the distribution of 8 health determinants (smoking habit, alcohol use, body mass index [BMI], physical activity, social participation, family visits, vaccination, and preventive visits) and their impact on 1-year mortality. RESULTS: During the one-year follow up, 611 (20%) participants died. Overweight (HR 0.79; 95% C.I. 0.64-0.97) and obesity (HR 0.64; 95% C.I. 0.48-0.87) resulted associated with lower mortality then normal weight. Similarly, physical activity (HR 0.67; 95% C.I. 0.54-0.83), social activities (HR 0.63; 95% C.I. 0.51-0.78), influenza vaccination (HR 0.66; 95% C.I. 0.55-0.80) and pneumococcal vaccination (HR 0.76 95% C.I. 0.63-0.93) were associated with lower mortality. Conversely, underweight (HR 1.28; 95% C.I. 1.03-1.60) and frequent family visits (HR 1.75; 95% C.I. 1.27-2.42) were associated with higher mortality. CONCLUSIONS: Health determinants in older NH residents depart from those usually accounted for in younger and fitter populations. Ad hoc studies are warranted in order to describe other relevant aspects of health in frail older adults, with special attention on those institutionalized, with the ultimate goal of improving the quality of care and life.

• MeSH
• Exercise MeSH
• Thinness MeSH
• Body Mass Index MeSH
• Interpersonal Relations MeSH
• Cohort Studies MeSH
• Smoking MeSH
• Frail Elderly statistics & numerical data   MeSH
• Humans MeSH
• Overweight MeSH
• Nursing Homes statistics & numerical data   MeSH
• Alcohol Drinking MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Vaccination MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe epidemiology   MeSH

AIM: Drugs may interact with geriatric syndromes by playing a role in the continuation, recurrence or worsening of these conditions. Aim of this study is to assess the prevalence of interactions between drugs and three common geriatric syndromes (delirium, falls and urinary incontinence) among older adults in nursing home and home care in Europe. METHODS: We performed a cross-sectional multicenter study among 4023 nursing home residents participating in the Services and Health for Elderly in Long-TERm care (Shelter) project and 1469 home care patients participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project. Exposure to interactions between drugs and geriatric syndromes was assessed by 2015 Beers criteria. RESULTS: 790/4023 (19.6%) residents in the Shelter Project and 179/1469 (12.2%) home care patients in the IBenC Project presented with one or more drug interactions with geriatric syndromes. In the Shelter project, 288/373 (77.2%) residents experiencing a fall, 429/659 (65.1%) presenting with delirium and 180/2765 (6.5%) with urinary incontinence were on one or more interacting drugs. In the IBenC project, 78/172 (45.3%) participants experiencing a fall, 80/182 (44.0%) presenting with delirium and 36/504 (7.1%) with urinary incontinence were on one or more interacting drugs. CONCLUSION: Drug-geriatric syndromes interactions are common in long-term care patients. Future studies and interventions aimed at improving pharmacological prescription in the long-term care setting should assess not only drug-drug and drug-disease interactions, but also interactions involving geriatric syndromes.

• MeSH
• Delirium epidemiology   MeSH
• Long-Term Care statistics & numerical data   MeSH
• Geriatric Assessment methods   MeSH
• Urinary Incontinence epidemiology   MeSH
• Humans MeSH
• Nursing Homes statistics & numerical data   MeSH
• Prevalence MeSH
• Cross-Sectional Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Home Care Services statistics & numerical data   MeSH
• Syndrome MeSH
• Accidental Falls statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe epidemiology   MeSH

Background: Influenza and pneumococcal vaccines have been proved to be effective and safe in preventing and controlling infection among elderly, reducing morbidity and mortality. However, some evidences raised health concerns related to these vaccinations. This study aims to identify prevalence and outcomes related to influenza and pneumococcal vaccinations in a large European population of frail old people living in nursing homes (NHs). Methods: We conducted a survival analysis of NH residents participating to the Services and Health for Elderly in Long-TERm project, a prospective cohort study collecting information on residents admitted to 57 NH in eight countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel). Clinical and demographical data were collected using the international resident assessement instrument for long-term care facilities. Incident mortality was recorded during 1-year follow-up. A shared-frailty Cox regression model was used to assess the impact of vaccination status on mortality. Results: Mean age of 3510 participants was 84.6 years (SD = 7.7). In total, 81.7 and 27.0% received influenza and pneumococcal vaccination, respectively. Overall, 727 (20.7%) residents died during the follow-up period. After adjusting for potential confounders, which included age, sex, number of diseases, depression, cognitive and functional status, influenza (HR = 0.80; 95% CI 0.66-0.97) and the combination of influenza and pneumococcal vaccination (HR = 0.72; 95% CI 0.57-0.91), but not pneumococcal vaccination alone (HR = 0.52; 95% CI 0.25-1.06), were associated with a statistically significant reduction in mortality in respect of no vaccinations. Conclusion: In a population of older adult living in NH influenza and the combination of influenza and pneumococcal vaccination were associated with a reduction in all-cause mortality respect to no vaccination.

• MeSH
• Survival Analysis MeSH
• Frail Elderly statistics & numerical data   MeSH
• Humans MeSH
• Mortality MeSH
• Nursing Homes statistics & numerical data   MeSH
• Pneumococcal Vaccines therapeutic use   MeSH
• Proportional Hazards Models MeSH
• Aged, 80 and over MeSH
• Influenza Vaccines therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe epidemiology   MeSH