Trends in the Prevalence and Comorbidities of Diabetes Mellitus in Nursing Home Residents in the United States: 1995-2004

Divisions of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 04/2010; 58(4):724-30. DOI: 10.1111/j.1532-5415.2010.02786.x
Source: PubMed


To estimate trends in the prevalence and comorbidities of diabetes mellitus (DM) in U.S. nursing homes from 1995 to 2004.
SAS callable SUDAAN was used to adjust for the complex sample design and assess changes in prevalence of DM and comorbidities during the study period in the National Nursing Home Surveys. Trends were assessed using weighted least squares linear regression. Multiple logistic regressions were used to calculate predictive margins.
A continuing series of two-stage, cross-sectional probability national sampling surveys.
Residents aged 55 and older: 1995 (n=7,722), 1997 (n=7,717), 1999 (n=7,809), and 2004 (n=12,786).
DM and its comorbidities identified using a standard set of diagnosis codes.
The estimated crude prevalence of DM increased from 16.9% in 1995 to 26.4% in 2004 in male nursing home residents and from 16.1% to 22.2% in female residents (all P<.05). Male and female residents aged 85 and older and those with high functional impairment showed a significant increasing trend in DM (all P<.05). In people with DM, multivariate-adjusted prevalence of cardiovascular disease increased from 59.6% to 75.4% for men and from 68.1% to 78.7% for women (all P<.05). Prevalence of most other comorbidities did not increase significantly.
The burden of DM in residents of U.S. nursing homes has increased since 1995. This could be due to increasing DM prevalence in the general population or to changes in the population that nursing homes serve. Nursing home care practices may need to change to meet residents' changing needs.

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Available from: William S Pearson, Oct 14, 2014
    • "The intensity of residents' needs in five activities of daily living (ADLs, transferring, eating, toileting, dressing, and bathing) was aggregated ≤2, 3, and 4-5). We only included four ADLs (eating, toileting, dressing, and bathing) in the trend analysis of influenza vaccination and pneumococcal vaccination from 1995 to 2004 because of a wording change for the transferring measure in the 2004 NNHS (Zhang et al., 2010). Residents' comorbidities were identified from the recorded current or admission diagnoses using ICD 9 (the International Classification of Diseases , Ninth Revision, Clinical Modification) codes (nervous system, infectious/parasitic , cancer, endocrine/metabolic, blood, circulatory, respiratory, digestive, genitourinary, skin, musculoskeletal, injury and poisoning, other mental disorder, symptoms and ill-defined conditions, and supplementary classification). "
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    • "in females, P < 0.05) [9]. For the oldest residents (aged ≥85 years), the prevalence increased from 13.1–19.5% in males (P = 0.02) and from 11.3–16.1% in females (P = 0.04) [9]. A more recent survey showed a further increase in the prevalence affecting approximately 32.8% of residents [10]. "
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