Racial and Socioeconomic Differences in Psychiatric Symptoms in Nursing Home Residents: A Minimum Data Set–Based Pilot Study

Abstract

Little research has explored racial and socioeconomic differences in the presence, detection, and treatment of neuropsychiatric symptoms in nursing home residents. To evaluate racial and socioeconomic differences on mood and behavior Minimum Data Set (MDS) recorded symptoms, MDS recorded psychiatric diagnoses, and MDS identified psychotropic medication use. Data were obtained through a cross-sectional review of MDS data of 290 African-American and white residents of 2 nursing homes. The association between age, gender, race, and pay status with mood and behavior patterns, psychiatric diagnoses, and use of psychotropic medication was evaluated. White residents were more likely than African American residents to have MDS recorded psychiatric diagnoses (odds ratio, OR = 3.24), but there were no significant racial differences in recorded mood or behavior symptomatology or in the pharmacologic treatment of mental illness. Medicaid recipients were more likely than nonrecipients to have behavior symptoms (OR = 2.09), have a psychiatric diagnosis (OR = 2.91), and receive psychotropic medications in the absence of a psychiatric diagnosis (OR = 3.62). Pay status was associated with recorded symptoms, diagnoses, and medications, but racial differences were found only for recorded diagnoses.