Defining Vitality Using Physical and Mental Well-Being Measures in Nursing Homes: A Prospective Study

OBJECTIVES: To propose an objective definition of vitality and to evaluate its predictive value regarding the evolution of functional ability, as well as the risk of hospitalization and mortality in very old NH residents. DESIGN: Observational study. SETTINGS: Nursing homes. PARTICIPANTS: 541 participants. MEASUREMENTS: We operationalized tree definitions of vitality (binary variables discriminating vital from non-vital individuals): Mental vitality, assessed using three items of the geriatric depression scale; Physical vitality measured through hand grip strength test; and combined vitality, which combined mental and physical vitality definitions. Outcome measures were the 1-year evolution of functional ability as measured by a scale of activities of daily living (ADL) (score from 0 to 6) and the incidence of hospitalizations and mortality (time-to-event). RESULTS: First, 204 (37.7%) residents were defined as mentally vital. Second, 139 (27.5%) residents were defined as physically vital. And 52 (9.6%) were defined as vital when combining physical and. Combined vitality was associated with a reduced risk of hospitalization compared to combined non-vitality. Physically vital residents were associated with a reduced risk of mortality. No prospective associations were found between vital and non-vital individuals on the evolution of ADL scores across the three vitality definitions. But mentally vital individuals were associated with a worsening of ADL score. CONCLUSIONS: Better combined vitality seems to be associated with a reduced risk for hospitalizations, but more studies are needed to confirm a valid measurement of vitality in people living in NH in regards to ADL and mortality. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is available for this article at 10.1007/s12603-019-1285-8 and is accessible for authorized users.