The 130th Annual Meeting of APHA

Abstract #35208

Gary S. Brooks--Award Winner, DrPH, PT, School of Health Professions, Grand Valley State University, One Campus Drive, Allendale, MI 49401-9403, 616-895-3509, brooksg@gvsu.edu and David Strogatz, PhD, School of Public Health, SUNY-Albany, One University Place, Albany, NY 12144-2345.

BACKGROUND: Few studies have investigated the relationship between diabetes and functional status of residents in long-term care facilities. METHODS: This study used a retrospective cohort design to assess the effect of prevalent diabetes on decline in four activities of daily living (ADL) in New York State nursing homes. Subjects included residents, age 55 and older, who were not cognitively impaired. Data from the Minimum Data Set (MDS) were used to create dichotomous measures of decline in transfers, bed mobility, toilet use and eating. Diabetes status was ascertained from a dichotomous diagnosis field in the MDS. Crude associations between diabetes and decline in each ADL were determined by 2x2 contingency table analysis. Multivariate logistic regression models examined associations between diabetes and ADL decline, adjusting for demographic, clinical and facility-level covariates and comorbidities. RESULTS: There was a crude association between diabetes and decline in ability to transfer (relative risk=1.25, 95% confidence interval=1.08 - 1.44). This association persisted for residents age 65 and older after multivariate adjustment (odds ratio=1.31, 95% confidence interval=1.07 - 1.60). No associations between diabetes and decline in the other three ADLs were found. CONCLUSIONS: Diabetes was modestly associated with deterioration in nursing home residents' ability to transfer. These findings help to shed light on the natural history of functional decline in long-term care facilities, and may assist long-term care providers in identification of functional activities that are at higher risk of decline in the presence of diabetes.

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