Neurological Impairment Among Elderly African-American Nursing Home Residents

In this pilot study, 288 elderly African-American and 482 white residents of 10 nursing homes in Wayne County, Michigan, were compared for neurological impairment. The frequency of diagnosis of neurological impairment was equivalent for African-American and white males, but greater for African-American females than for white females. Cerebral vascular accident (CVA, or stroke) and nonspecific dementia were the most common neurological diagnoses for all groups. For males but not females, there was a statistically significant difference in the causes of neurological impairment, with more African-Americans diagnosed as having CVA, and more whites diagnosed as having nonspecific dementia. While the incidence of neurological impairment in African-Americans exceeded that of whites, predominantly white nursing homes offered more sophisticated care. This suggests the need to review the means by which comprehensive nursing home care may be expanded in the African-American community.