Analysis of Racial and Ethnic Disparities as Possible Risk Factors for Development of Incontinence by Nursing Home Residents.
Incontinence is a common health problem among nursing home (NH) residents. Differences between black and white NH residents in incontinence prevalence have been reported. Although reducing health disparities is a principal objective of the national health care agenda, little is known about disparities in incidence of new incontinence in NHs. The purpose of this study was to assess whether there were racial/ethnic disparities in the time to development of incontinence in adults over age 65 who had been continent on NH admission. If no racial or ethnic disparities in time to incontinence were found, other predictors of time to incontinence would be explored. Three national databases were sources of data on 42,693 adults over 65 admitted to 446 for-profit NHs in a national chain. Multi-level predictors of time to any type of incontinence were analyzed, using Cox proportional hazards regression for white Non-Hispanic NH admissions and the Peters-Belson method for minority NH admissions: American Indians/Alaskan Natives, Asians/Pacific Islanders, Black non-Hispanics, and Hispanics. No racial/ethnic disparities in time to incontinence were found. Approximately 30% of all racial/ethnic groups had developed incontinence by 6 months. Those who developed incontinence sooner were older and had greater deficits in activities of daily living (ADL) and cognition. Results were consistent with past evidence and suggest that interventions to maintain continence from the time of admission should be applied across racial/ethnic groups.
School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street, Minneapolis, MN, 55455.
Donna Z
DZ
Bliss
School of Nursing, University of Minnesota, Minneapolis, MN.
Olga V
OV
Gurvich
School of Nursing, University of Minnesota, Minneapolis, MN.
Kay
K
Savik
School of Public Health, University of Minnesota, Minneapolis, MN.
Lynn E
LE
Eberly
School of Nursing and Public Health, University of Minnesota, Minneapolis, MN.
Susan
S
Harms
School of Nursing, University of Minnesota, Minneapolis, MN.
Jean F
JF
Wyman
School of Nursing, University of Minnesota, Minneapolis, MN.
Christine
C
Mueller
School of Nursing and Public Health, University of Minnesota, Minneapolis, MN.
Judith
J
Garrard
School of Nursing and Public Health, University of Minnesota, Minneapolis, MN.
Beth
B
Virnig
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D016016:Proportional Hazards Models; D012307:Risk Factors; D014549:Urinary Incontinence / Q000208:ethnology*
disparities; epidemiology; incidence; incontinence; nursing home; proportional hazards; race and ethnicity