Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 54, Issue 7 M365-M369, Copyright © 1999 by The Gerontological Society of America
Nursing home admission for African Americans with Alzheimer's disease
SC Miller, TR Prohaska and SE Furner
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, USA. [email protected]
BACKGROUND: For African Americans with Alzheimer's disease (AD), little is
known about the time to, and risk factors for, nursing home admission
(NHA). Using Consortium To Establish a Registry for Alzheimer's Disease
(CERAD) data, this study provides information on NHA for African Americans.
METHODS: This longitudinal study followed subjects (N=122) for as long as 7
years and used survival analysis methodology and variable values at
baseline and at follow-up to identify NHA risk factors. Studied were
sociodemographic variables, physical symptom and disease status variables,
the Blessed Dementia Rating Scale (including subscores), the Clinical
Dementia Rating (CDR), and the Mini-Mental State Examination. RESULTS: Only
25% of African Americans with AD were estimated to have had a NHA by 3.4
years (confidence interval 2.1, 5.4). Being unmarried resulted in a five
times earlier NHA (p< .01), and each unit increase in the CDR resulted
in a 74% earlier NHA (p<.01). In the absence of the CDR, limitation in
activities of daily living was associated with earlier NHA (p<.05).
CONCLUSIONS: Findings suggest that African Americans with AD spend a
substantial time in the community prior to NHA, a longer time than observed
in similar studies among whites. This raises public health and clinical
concern that African Americans with AD may be residing in the community
with substantial unmet needs, and that their caregivers have potentially
high levels of burden. The independent associations with time to NHA
observed here, although few in number, are consistent with other related
research.
