This article is more than 5 years old. Information may no longer be current.

Homebound older adults face increased risk of mortality

Homebound status was found to increased 2-year mortality, according to research presented at the annual American Geriatrics Society meeting.

Tacara N. Soones, MD, an assistant professor of geriatrics and palliative medicine at The Mount Sinai Hospital and colleagues reported that the risk persisted after adjusting for several other factors.

"There are approximately 2 million homebound older adults in the United States," Soones and colleagues wrote. "Although their multi-morbidity, disability and poor access to care would suggest an increased risk of death, the prognosis of homebound status is uncertain."

Researchers evaluated a sample of 6,400 adults aged 65 and older from the National Health and Aging Trends Study. The participants were all Medicare beneficiaries who completed annual interviews regarding disability and function. Soones and colleagues classified the participants by their homebound status: If they left their home never or rarely, left with assistance or had difficulty or left without help or difficulty, which translated to homebound, semihomebound and nonhomebound, respectively.

Data revealed that 7.5% of participants were homebound, 18.1% were semihomebound and 73.8% were nonhomebound. Researchers found that 2-year mortality was 5.8% in nonhomebound participants, 21.3% in semihomebound participants and 40.3% in homebound participants, after unadjusted analyses.

After adjusting for functional status, demographics, social support and comorbidities, homebound status was associated with increased 2-year mortality (HR = 1.81; 95% CI, 1.41-2.31; P < .001). In addition, at the 2-year point, Soones and colleagues found that 12.1% of homebound participants were no longer homebound after improvement, while 26.9% remained homebound, 14.9% were semihomebound and 5.8% moved to a nursing home.

"Homebound status is an independent risk factor for death among older adults," Soones and colleagues concluded. "Clinicians and health policy makers should use this prognostic information to develop long-term care plans, models of care, and health care policy to meet the needs of homebound older adults." – by Chelsea Frajerman Pardes

Reference:

Soones TN, et al. Mortality and nursing home status at 2 years in older, homebound adults: An analysis of the National Health and Aging Trends Study. Presented at: American Geriatrics Society 2016 Annual Scientific Meeting; May 19-21; Long Beach, Calif.

Disclosures: The National Health and Aging Trends Study is sponsored by grant NIA U01AG32947. Please see the full abstract for a complete list of all other authors' relevant financial disclosures.