ArticleJournal of the American Geriatrics Society2023
Return to community living and mortality after moving to a long-term care facility: A nationally representative cohort study.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Phenotypes of Older Adults Planning for Alzheimer's Disease Support.Journal of the American Geriatrics Society · 2026Article
- Losses to Follow-Up in a Nationally Representative Study of Community-Living Older Americans: Two Approaches to Censoring and Implications for Mortality Outcomes.Journal of the American Geriatrics Society · 2026Article
- Incomplete Ascertainment of Mortality in a Nationally Representative Longitudinal Study of Community-Living Older Americans.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Association of Fragmented Readmissions and Electronic Information Sharing With Discharge Destination Among Older Adults.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundRecent long-term care facility (LTCF) policy has focused on transitioning nursing home (NH) residents back to community settings, yet we lack recent descriptions of this phenomenon and how it compares in assisted living (AL).
methodsUsing the National Health and Aging Trends Study, we studied adults over age 65 who had moved from community living into an LTCF between 2011 and 2018. Persons or their proxies reported residence in annual interviews. NH was defined by facility staff. ALs were multi-unit buildings helping with activities of daily living. We excluded temporary short-stay NH patients and independent AL residents. Our primary outcome was cumulative incidence of return to community living, with death as co-primary outcome and modeled as a competing risk, stratified by NH versus AL entry. We identified covariates (age, gender, race/ethnicity, dementia, activity limitations, and prior living arrangement) associated with return to community living through bivariate and multivariable logistic regression.
resultsAmong 739 participants, weighted mean age was 84 years (SD 7.5), 66% were women, 13% were non-White, 57% had dementia, and 41% entered NH. At 1, 2, and 4 years, the cumulative incidence of return to community living was 2.9% (95% CIs: 1.9%-4.3%), 6.4% (4.7%-8.4%), and 7.4% (5.5%-9.8%); the cumulative incidence of death was 28% (95% CIs: 24%-31%), 44% (40%-48%) and 66% (61%-70%). Outcomes were similar in persons entering NH versus AL. Older persons (aOR 0.88, 95% CI 0.83-0.94), those with dementia (aOR 0.33, 95% CI 0.12-0.88), and those previously living alone (aOR 0.39, 95% CI 0.17-0.89) were less likely to return.
conclusionsFew returned to community living after entering either NH or AL. Mortality was similar. Results highlight limits in transitioning persons out of LTCFs and the need to observe AL use to ensure policies do not merely displace persons between institutional care sectors.
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