Institutionalized older adults in a health district in the United Arab Emirates: Health status and utilization rate

Background: Little is known about the rate of institutionalization and heal th status of nursing home INH) type patients living in the Middle East. Thi s study was set in the Al-Ain Medical District, a geographically discrete r egion of the United Arab Emirates, a country with a developing economy loca ted on the shores of the Arabian Gulf. NH-type patients were defined as peo ple aged 60 years and older who were admitted to a hospital or a long-term institutionalized setting for at least 6 weeks and with no evidence of an e xpectation of discharge at the time of the evaluation. Objective: To determ ine the clinical, functional, cognitive, and nutritional status of NH-type patients living in a defined community within a developing country. Method: Cross-sectional survey. Results: All NH-type patients were identified, and all were included in this study (n = 47, 100% participation rate). All wer e located within three public institutions, none of which was a dedicated N H facility. The rate of institutionalization was 7.0-14.0 per 1,000 people aged 65 or older. The age distribution was 30% (60-74 years), 49% (75-84 ye ars), and 21% (85+ years). The length of stay was 3.8 years. The female:mal e ratio was 1.6. All except 1 had a neurological disorder, and 89% had deme ntia. The cognitive deficits were severe with only 61% alert, 41% able to s peak, 17% orientated in place, and 15% orientated in time. The functional s tatus was also poor: 98% received assistance with all instrumental activiti es of daily living, 85% received assistance with five activities of daily l iving, and 94% were bed bound. The nutritional status was also impaired wit h a mean body weight of 45 +/- 14 kg and a mean albumin level of 3.1 +/- 0. 6 g/dl. When compared with the USA data from the National Center for Health Statistics, the study population was younger, had a longer length of stay, a lower female:male ratio, a higher rate of neurological diseases and deme ntia, and were far more dependent and disorientated. The rate of institutio nalization was one sixth to one third of that in the USA. Conclusion: From these data we concluded that this region has a distinctly different populat ion of institutionalized older people who demonstrate greater impairments i n all domains of health status. Copyright (C) 2001 S. Karger AG, Basel.