Differences in resident characteristics and prevalence of urinary incontinence in nursing homes in the southeastern United States.
BACKGROUND
Relatively little is known about differences in the prevalence of urinary incontinence (UI) by race and region in the United States.


OBJECTIVE
To use the 1999-2002 Centers for Medicare and Medicaid Services (CMS) Minimum Data Set (MDS), Atlanta Region, to investigate the prevalence of UI among African American and Caucasian residents of nursing homes (NH) in the southeastern United States.


METHODS
A repeated-measures, two time-period design was employed. Data for 95,911 residents in 7,640 NH were extracted using the study's inclusion and exclusion criteria. Residents' admission and annual assessment records were accessed; UI presence and relevant indicators were captured; and admission and postadmission UI prevalence rates were determined by region, state, race, and gender. Logistic regression, adjusting for residents' demographics, morbidity status, bed mobility, and cognitive and functional statuses, was conducted also.


RESULTS
The majority of residents were Caucasian (82.4%) and women (76.5%) with mean (+/-SD) age of 82.7 +/- 7.58 years. Regional UI prevalence was 65.4% at admission and 74.3% postadmission. Postadmission, 73.5% of Caucasian and 78.1% of African Americans were incontinent. Similarly, 72.2% of men and 75% of women were incontinent. For African Americans postadmission, adjusted odds of UI were OR = 1.07 (95% CI: 1.01, 1.14).


CONCLUSIONS
Prevalence of UI was high in this region and the odds of UI was significantly higher among African Americans in two of eight states, suggesting racial disparity in this condition in these states. Factors contributing to this disparity should be explored to increase quality care to vulnerable populations.
Boyington
Josephine E A
JE
The Institute for Health, Social and Community Research, Shaw University, Raleigh, North Carolina 27601, USA. jboyington@shawu.edu
Howard
Daniel L
DL
Carter-Edwards
Lori
L
Gooden
Kyna M
KM
Erdem
Nurum
N
Jallah
Yhenneko
Y
Busby-Whitehead
Jan
J
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D011159:Population Surveillance; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D017678:Sex Distribution; D015144:Southeastern United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000175:diagnosis / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*