title: [Association between homebound status and newly certified need of care among elderly in a rural community: the Iwate-Kenpoku cohort (Iwate-KENCO) study].
abstract: OBJECTIVE
  The purpose of this study was to evaluate the association between homebound status and newly certified need of care among elderly in a rural community and to clarify the characteristics of those in homebound status.
  
  
  METHODS
  The Iwate-KENpoku COhort (Iwate-KENCO) study (26,469 participants) spanned the period from 2002 to 2004 and was conducted in northern Iwate Prefecture, Japan. In the present study, 12,056 elderly (men, 4,751; women, 7,305) participated after being screened for eligibility (> or =65 years of age; without certification for need of care; and without a history of stroke, cardiac heart failure, or ischemic heart disease). Being homebound was operationally defined as walking outdoors for less than 5 minutes per day. Cox's proportional hazard model was used to estimate the hazard risk (HR) for newly certified need of care and the 95% confidence interval (95% CI) after controlling for confounding factors by gender.
  
  
  RESULTS
  After a mean follow-up period of 2.65 years, 200 men (4.2%) and 412 women (5.6%) obtained certification for need of care. Homebound status was significantly associated with newly certified need of care in women (HR=1.64, 95%CI=1.29-2.09), but not in men (HR=1.07, 95%CI=0.76-1.52). Homebound status among elderly women was associated with nutritional status, missing teeth, and irregular daily rhythms.
  
  
  CONCLUSIONS
  These findings suggest that being homebound is a risk factor for elderly women receiving certification for need of care.
authors.affiliation: Department of Public Health, Fukushima Medical University, School of Medicine.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.forename: Kozo
authors.initials: K
authors.lastname: Tanno
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Onoda
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Itai
authors.forename: Kazuko
authors.initials: K
authors.lastname: Kawamura
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Sakata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006301:Health Services Needs and Demand / Q000592:standards*; D018577:Homebound Persons; D006801:Humans; D007564:Japan; D008297:Male; D012424:Rural Population