[Incidence and prognosis of, and risk factors for the home-bound in a community elderly population].
This longitudinal study examined numbers of homebound and bed bound individuals over time, and risk factors in a rural community elderly populations. A total of 731 older persons who needed no assistance of another person in traveling from their homes participated in the baseline survey in 1992 and were assessed annually for their ability to travel for subsequent six-years. We defined operationally a homebound status as the necessity for assistance of another person to be able to leave home, but without being bedbound. During the follow-up period, 86 homebound (23.7 per 1,000 person-years) and 32 bedbound cases (8.4 per 1,000 person-years) were noted, the former being 2.8 times more likely to occur. Of the newly bound cases 26% returned to a state capable of leaving home by themselves one year later, and maintained this independent living level even two years later. Of the other cases who remained as homebound or bedbound one year later, only one (1/31) had returned to independent living after two years; most of them became bedbound at home, hospital admitted or deceased. Stepwise multiple logistic regression analysis showed that independent risk factors for the homebound include older age, male gender, slower walking speed, history of hospital admission in the previous year, lower masticatory ability, and higher level of serum beta 2-microglobin. These results indicate that health promotion programs for prevention of becoming homebound among community elderly people should target more intensively assistance to maintaining walking and masticatory ability. In addition, public health professionals should pay more attention to elderly people shortly after hospital discharge.
Shinkai
S
S
Department of Community Health, Tokyo Metropolitan Institute of Gerontology.
Watanabe
S
S
Kumagai
S
S
Yoshida
Y
Y
Fujiwara
Y
Y
Yoshida
H
H
Ishizaki
T
T
Yukawa
H
H
Kim
H K
HK
Suzuki
T
T
Amano
H
H
Shibata
H
H
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D018577:Homebound Persons; D006801:Humans; D008297:Male; D008409:Mastication; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D016138:Walking