The Association Between Relocations and Health Outcomes in Nursing Home Residents: A Retrospective Cohort Study

The aim of this study was to investigate the effect of relocations on mood, cognition, functional status, and mortality across diverse nursing homes.

A retrospective study with data from the Dutch InterRAI-LTCF routine care cohort.

Long-stay nursing home residents aged 65 years and older (n = 8603) from 167 nursing home facilities, of whom 1250 participants relocated at least once.

We included observations from 2004 through 2019 (excluding relocations in the COVID-19 period) and residents with at least 1 regular assessment. Residents who were first relocated to a hospice were excluded. We used pooled logistic regression with inverse probability weighting to analyze short- and long-term relationships of relocation with mood, cognition, functional status, and mortality, adjusted for confounders. Short term was defined as the first postrelocation assessment or the first 3 months for mortality.

In the short term, we found an adjusted hazard ratio (HR) of 1.11 (95% CI, 0.98-1.26) for decreased mood, 1.29 (95% CI, 1.13-1.47) for impaired cognition, 1.88 (95% CI, 1.65-2.14) for impaired activities of daily living, and 1.03 (95% CI, 0.80-1.33) for mortality. In the long term, we found similar HRs, except for mortality (HR, 0.88; 95% CI, 0.78-1.00).

Relocations across nursing homes were associated with an increased risk for more activities of daily living dependency and cognitive impairment. Further research is warranted to determine the role of reversed causation. The risk for decreased mood and mortality was comparable between relocated and nonrelocated residents.