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Keywords:

  • bathing disability;
  • environmental assessment;
  • epidemiology;
  • risk factors;
  • cohort study

OBJECTIVES: To determine whether the availability of bath aids may forestall the subsequent development of bathing disability.

DESIGN: Prospective cohort study.

SETTING: Greater New Haven, Connecticut.

PARTICIPANTS: Five hundred one nondisabled (required no personal assistance in bathing) community-living residents aged 73 and older.

MEASUREMENTS: The availability of five bath aids (grab bars, bath seat, nonskid mat or abrasive strips, handheld shower spray, and long-handled brush or sponge) was ascertained during a comprehensive home-based assessment. Subsequently, participants were followed with monthly telephone interviews to determine the onset of persistent (i.e., present for at least 2 consecutive months) disability in bathing and were evaluated for disability in three bathing subtasks (bathing transfers, washing whole body, and drying whole body) during the next home-based assessment, which was completed 18 months after the initial assessment.

RESULTS: The presence of a bath seat was associated with a greater likelihood of developing persistent disability in bathing and disability in each of the three bathing subtasks, although these associations were not statistically significant after adjustment for potential confounders. Nonsignificantly greater risk was also observed for grab bars, handheld shower spray, and long-handled brush or sponge. In the adjusted analysis, the presence of nonskid mats or abrasive strips was associated with a 23% lower risk (nonsignificant) of persistent bathing disability and a lower likelihood of developing disability in washing and drying one's whole body, with corresponding odds ratios of 0.28 (P=.003) and 0.38 (P=.030), respectively.

CONCLUSION: In this longitudinal study, the presence of bath aids, with the exception of nonskid mats or abrasive strips, did not forestall the subsequent development of bathing disability. Because it may not be possible to fully account for the effects of self-selection, clinical trials may be necessary to demonstrate the potential value of bath aids in community-living older persons.