Association between Mortality and Time Spent Out of Bed in Older-Adult Nursing Home Residents.

Abstract

Objectives: For older adults, spending time out of bed is important for preventing functional decline, but its relationship to mortality is not clear. In this study, we aimed to investigate the association between mortality and time spent out of bed in Japanese older-adult nursing home residents.

Design: We conducted a cohort study using data from the Long-term Care Information System for Evidence database.

Setting and participants: We used data collected between April 2022 and March 2024 from older-adult nursing home residents who required assistance with the activities of daily living.

Methods: We compared outcome data between residents who spent 6 or more hours per day out of bed (group L) and those who spent less than 6 hours per day out of bed (group S). The outcome was all-cause mortality. Data were analyzed using Kaplan-Meier curves and Cox regression models.

Results: Data from 185 older-adult nursing home residents (median age: 89 years; 141 women) were analyzed. Group L included 144 residents (77.8% of all participants). Of the 185 participants, 40 died during the observation period. Mortality in group L was significantly lower than in group S (16.7% vs 39.0%, P = .002). Kaplan-Meier curve analysis after the log-rank test revealed a significantly higher mortality in group S than group L. Univariate and multivariate Cox regression analyses with robust (Huber-White) standard errors identified the factor of time spent out of bed (≥6 h) as a significant and independent risk factor for mortality.

Conclusion and implications: More time spent out of bed is associated with lower mortality in older-adult nursing home residents who require assistance with the activities of daily living.