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Characteristics of Rural Homebound Older Adults: A Community‐Based Study
Author(s) -
Ganguli Mary,
Fox Andrea,
Gilby Joanne,
Belle Steven
Publication year - 1996
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1996.tb06403.x
Subject(s) - medicine , gerontology , activities of daily living , confidence interval , depression (economics) , odds ratio , epidemiology , mental health , geriatrics , demography , physical therapy , psychiatry , pathology , sociology , economics , macroeconomics
OBJECTIVE : To determine the frequency and characteristics of homebound older adults in a rural community. DESIGN : An epidemiological survey of an age‐stratified random community sample. SETTING : The rural mid‐Monongahela Valley in Southwestern Pennsylvania. PARTICIPANTS : A total of 878 noninstitutionalized persons aged 68 years and older, fluent in English, and with at least grade 6 education. MEASUREMENTS : The frequency with which subjects left their homes, the Mini‐Mental State Examination (MMSE) score, and additional information on demographics, self‐reported health problems, health services utilization, IADLs, depression, and social support were measured. RESULTS : 10.3% of the sample was classified as home‐bound. In univariate analyses, being homebound was found to be associated significantly ( P < .001) with being older, female, and widowed and with MMSE and IADL impairment, with more depressive symptoms and worse social supports, fair to poor self‐rated general health, weight loss, and histories of stroke, angina, arthritis of the spine, and falls. In a multiple regression model, variables associated independently with homebound status were gender (odds ratio = 9.4, 95% confidence interval = 3.6 − 24.9), weight loss (OR = 3.7, CI = 1.7 − 8.2), IADL impairment (OR = 2.6, CI = 2.1 − 3.1), and depressive symptoms (OR = 2.1, CI = 1.3 − 3.2). Being homebound was also associated with recent acute hospitalization and use of home health and social services. CONCLUSIONS : These data provide evidence that homebound older adults have a disproportionate share of morbidity and disability and suggest a sociodemographic and clinical profile to help identify those older people at risk of being or becoming homebound. They also point to the need for home‐based health services for the older adults, particularly in medically underserved communities such as rural areas. J Am Geriatr Soc 44:363–370, 1996 .