Bathing disability and the risk of long-term admission to a nursing home.
BACKGROUND
The prevalence of disability in bathing and the likelihood of a long-term nursing home admission increase substantially with age. We performed a prospective study to determine whether the occurrence of persistent disability in bathing is associated with the risk of a long-term nursing home admission, independent of potential confounders, including persistent disability in other essential activities of daily living.


METHODS
We studied 754 community-living persons, 70 years old or older, who were nondisabled in four essential activities of daily living. Participants were followed with monthly telephone interviews for a median of 75 months to determine the occurrence of persistent (i.e., present for at least 2 consecutive months) disability in bathing and the time to the first long-term nursing home admission, defined as longer than 3 months.


RESULTS
One hundred thirteen (15.0%) participants had a long-term nursing home admission. At least one episode of persistent bathing disability occurred among 59 (52.2%) participants with a long-term nursing home admission and 210 (32.8%) without a long-term admission (p <.001). In a proportional hazards model that was fully adjusted for potential confounders, the occurrence of persistent bathing disability increased the risk of a long-term nursing home admission by 77% (hazard ratio 1.77, 95% confidence interval 1.05 to 2.98), but had no effect on the risk of a short-term nursing home admission (hazard ratio 0.87, 95% confidence interval 0.51 to 1.49).


CONCLUSIONS
Among community-living older persons, the occurrence of persistent disability in bathing is independently associated with the risk of a long-term nursing home admission, but has no effect on short-term admissions. Interventions directed at the prevention and remediation of bathing disability have the potential to reduce the burden and expense of long-term care services.
Gill
Thomas M
TM
Yale University School of Medicine, Dorothy Adler Geriatric Assessment Center, 20 York Street, New Haven, CT 06504, USA. thomas.gill@yale.edu
Allore
Heather G
HG
Han
Ling
L
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001494:Baths; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010343:Patient Admission; D011446:Prospective Studies; D012307:Risk Factors