Two-Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study

Tacara Soones, Alex Federman, Bruce Leff, Albert L. Siu, Katherine Ornstein

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives: To determine the association between homebound status and mortality. Design: Cross-sectional. Setting: Annual, in-person interviews. Participants: A nationally representative sample of community-dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). Measurements: Two-year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). Results: In unadjusted analyses, 2-year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2-year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63–2.65, P <.001). Half of older community-dwelling Medicare beneficiaries were homebound in the year before death. Conclusion: Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.

Original languageEnglish (US)
Pages (from-to)123-129
Number of pages7
JournalJournal of the American Geriatrics Society
Volume65
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Independent Living
Mortality
Health
Medicare
Comorbidity
Confidence Intervals
Interviews
Delivery of Health Care

Keywords

  • cross-sectional studies
  • epidemiology
  • homebound
  • mortality
  • United States

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Two-Year Mortality in Homebound Older Adults : An Analysis of the National Health and Aging Trends Study. / Soones, Tacara; Federman, Alex; Leff, Bruce; Siu, Albert L.; Ornstein, Katherine.

In: Journal of the American Geriatrics Society, Vol. 65, No. 1, 01.01.2017, p. 123-129.

Research output: Contribution to journalArticle

Soones, Tacara ; Federman, Alex ; Leff, Bruce ; Siu, Albert L. ; Ornstein, Katherine. / Two-Year Mortality in Homebound Older Adults : An Analysis of the National Health and Aging Trends Study. In: Journal of the American Geriatrics Society. 2017 ; Vol. 65, No. 1. pp. 123-129.
@article{c16266da26274a799466bb87da7a07c5,
title = "Two-Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study",
abstract = "Objectives: To determine the association between homebound status and mortality. Design: Cross-sectional. Setting: Annual, in-person interviews. Participants: A nationally representative sample of community-dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). Measurements: Two-year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). Results: In unadjusted analyses, 2-year mortality was 40.3{\%} in homebound participants, 21.3{\%} in those who were semihomebound and 5.8{\%} in those who were nonhomebound. Homebound status was associated with greater 2-year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95{\%} confidence interval = 1.63–2.65, P <.001). Half of older community-dwelling Medicare beneficiaries were homebound in the year before death. Conclusion: Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.",
keywords = "cross-sectional studies, epidemiology, homebound, mortality, United States",
author = "Tacara Soones and Alex Federman and Bruce Leff and Siu, {Albert L.} and Katherine Ornstein",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/jgs.14467",
language = "English (US)",
volume = "65",
pages = "123--129",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Two-Year Mortality in Homebound Older Adults

T2 - An Analysis of the National Health and Aging Trends Study

AU - Soones, Tacara

AU - Federman, Alex

AU - Leff, Bruce

AU - Siu, Albert L.

AU - Ornstein, Katherine

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: To determine the association between homebound status and mortality. Design: Cross-sectional. Setting: Annual, in-person interviews. Participants: A nationally representative sample of community-dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). Measurements: Two-year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). Results: In unadjusted analyses, 2-year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2-year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63–2.65, P <.001). Half of older community-dwelling Medicare beneficiaries were homebound in the year before death. Conclusion: Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.

AB - Objectives: To determine the association between homebound status and mortality. Design: Cross-sectional. Setting: Annual, in-person interviews. Participants: A nationally representative sample of community-dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). Measurements: Two-year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). Results: In unadjusted analyses, 2-year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2-year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63–2.65, P <.001). Half of older community-dwelling Medicare beneficiaries were homebound in the year before death. Conclusion: Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.

KW - cross-sectional studies

KW - epidemiology

KW - homebound

KW - mortality

KW - United States

UR - http://www.scopus.com/inward/record.url?scp=84992482430&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992482430&partnerID=8YFLogxK

U2 - 10.1111/jgs.14467

DO - 10.1111/jgs.14467

M3 - Article

C2 - 27641001

AN - SCOPUS:84992482430

VL - 65

SP - 123

EP - 129

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 1

ER -