The protective effect of social engagement on mortality in long-term care

OBJECTIVES: To examine the effect of social engagement (SE) on mortality in long-term care. DESIGN: A retrospective cohort study. SETTING: A 725-bed long-term care facility. PARTICIPANTS: A total of 927 long-term care residents who had SE measuremen ts and did not have a serious communication problem. MEASUREMENTS: Minimum Data Set information including psychosocial items com prising an internally reliable and valid SE scale, and mortality risk facto r measurements. Mortality data during the 1721-day follow-up period was obt ained from facility records. RESULTS: Life table analyses indicate that higher levels of SE are associat ed with longer survival (P = .0001). Unadjusted proportional hazards analys es show that residents who did not engage socially were 2.3 times more like ly to die during the follow-up period compared with residents who were the most socially engaged. Multivariate adjusted analyses showed the protective effect of SE on mortality remained even after simultaneously adjusting for mortality risk factors. Residents who did not engage socially were 1.4 tim es as likely to die during the follow-up period compared with residents who were the most socially engaged. CONCLUSIONS: Increased levels of SE were associated with longer survival in dependent of mortality risk factors. SE may be a modifiable risk factor for death among long-term care residents, More research is needed to understan d psychological factors that may influence residents' desire and ability to engage socially.