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The dynamics of being homebound over time: A prospective study of Medicare beneficiaries, 2012–2018
Author(s) -
Ankuda Claire K.,
Husain Mohammed,
BollensLund Evan,
Leff Bruce,
Ritchie Christine S.,
Liu Shelley H.,
Ornstein Katherine A.
Publication year - 2021
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/jgs.17086
Subject(s) - medicine , gerontology , residence , longitudinal study , activities of daily living , bathing , prospective cohort study , nursing homes , population , demography , environmental health , physical therapy , nursing , surgery , pathology , sociology
Background/Objectives Approximately 2 million people, or 6% of older adults in the United States, are homebound. In cross‐sectional studies, homebound older adults have high levels of morbidity and mortality, but there is little evidence of longitudinal outcomes after becoming homebound. The aim of this research is to prospectively assess over 6 years the dynamics of homebound status, ongoing community residence, and death in a population of community‐dwelling older adults who are newly homebound. Design/setting Prospective cohort study using 2011–2018 data from the National Health and Aging Trends Study (NHATS), an annual, nationally‐representative longitudinal study of aging in the United States. Participants Two hundred and sixty seven newly homebound older adults in 2012. Measurements Homebound status was defined via self‐report as living in the community but rarely/never leaving home in the prior month. Semi‐homebound was defined as leaving the house only with difficulty or help. Results One year after becoming newly homebound, 33.1% remained homebound, 22.8% were completely independent, 23.8% were semi‐homebound, 2.2% were in a nursing home, and 18.0% died. Homebound status is highly dynamic; 6 years after becoming homebound, 13.5% remained homebound and 65.0% had died. Recovering from being homebound at 1 year was associated with younger age and lower baseline rates of receiving help with activities of daily living, in particular, with bathing. Conclusion Homebound status is a dynamic state. Even if transient, becoming homebound is strongly associated with functional decline and death. Identifying newly homebound older adults and developing interventions to mitigate associated negative consequences needs to be prioritized.