A national study showed that diagnoses varied by age group in nursing home residents under age 65

Fries, Brant E.; Wodchis, Walter P.; Blaum, Caroline; Buttar, Amna; Drabek, John; Morris, John N.

doi:10.1016/j.jclinepi.2004.07.001

« Previous Next »Journal of Clinical Epidemiology
Volume 58, Issue 2 , Pages 198-205, February 2005

A national study showed that diagnoses varied by age group in nursing home residents under age 65

Brant E. Fries
- Institute of Gerontology and School of Public Health, University of Michigan, 300 North Ingalls, Ann Arbor, MI 48109-2007, USA
- Ann Arbor VA Healthcare System Geriatric Research, Education and Clinical Center, Ann Arbor, MI, USA
- Corresponding author. Tel.: 734-936-2107; fax: 734-936-2116.
Walter P. Wodchis
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Gerontology and Michigan Health Services Research Initiative, University of Michigan, Ann Arbor, MI, USA
Caroline Blaum
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
Amna Buttar
- Indiana University School of Medicine, Indianapolis, Indiana, IN, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
John Drabek
- US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Washington, DC, USA
John N. Morris
- Research and Training Institute, Hebrew Rehabilitation Center for Aged, Boston, MA, USA

Abstract

Objective

Those aged <65 in nursing homes (NHs) are substantially different from elderly residents. This study uses data gathered from the Resident Assessment Instrument's Minimum Data Set (MDS) to describe these relatively rare residents.

Study design and setting

The study uses MDS assessments of close to three-quarter million residents in nine states from 1994 to 1996. Residents are described within chronological age group (0–4, 5–14, etc.). Factor analysis is used to develop diagnostic clusters, and the prevalence of these clusters, functional problems, other conditions, and treatments is described for each group.

Results

Thirteen diagnostic clusters describe nearly 85% of all NH residents and highlight differences between age groups. Pediatric residents are substantially more physically and cognitively impaired than young adult residents, and have the highest case mix burden of care. The youngest population primarily has diagnoses related to mental retardation and developmental disabilities, young adults have the highest prevalence of hemi- and quadriplegia, while older residents are typified by increasing prevalence of neurological diagnoses.

Conclusion

This study offers an initial description of NH residents <65. The prevalence of residents with unique conditions may suggest the need to modify the MDS assessment instrument.

Keywords: Minimum data set, Resident assessment instrument, Disabled, Non-elderly, Diagnosis