Home Modifications to Reduce Disability in Older Adults With Functional Disability

Abstract A large and growing population of older adults with multimorbidity, cognitive impairment, and functional disability live in the community but are homebound (never/rarely leave home). While homebound status is associated with decreased access to medical services and poor health outcomes, it is unclear how long individuals remain homebound. We used the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries age 65 and over, with survey weighting to assess duration of homebound status in the community. Among the incident homebound in 2016 (n=253) , only 28% remained homebound after 1 year. 21% died, 18% were recovered, and one-third left the home but still reported difficulty. As the locus of long-term care shifts from nursing homes to the community and models of care expand to serve the needs of the homebound, it is critical that we better understand the heterogeneity and transitions of the homebound population.

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Functional disability mediates the relationship between pain and depression among community-dwelling older adults: Age and sex as moderators

Geriatric Nursing ◽

10.1016/j.gerinurse.2020.12.010 ◽

2021 ◽

Vol 42 (1) ◽

pp. 137-144

Author(s):

Lili Ji ◽

Xiaoxia Qiao ◽

Yaru Jin ◽

Huaxin Si ◽

Xinyi Liu ◽

...

Keyword(s):

Older Adults ◽

Functional Disability ◽

Community Dwelling ◽

Community Dwelling Older Adults ◽

The Relationship ◽

Age And Sex

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Bathing Frequency and Onset of Functional Disability Among Japanese Older Adults: A Prospective 3-Year Cohort Study From the JAGES

Journal of Epidemiology ◽

10.2188/jea.je20180123 ◽

2019 ◽

Vol 29 (12) ◽

pp. 451-456

Author(s):

Akio Yagi ◽

Shinya Hayasaka ◽

Toshiyuki Ojima ◽

Yuri Sasaki ◽

Taishi Tsuji ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Functional Disability ◽

Japanese Older Adults

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A Model of Risk Reduction for Older Adults Vulnerable to Nursing Home Placement

Research and Theory for Nursing Practice ◽

10.1891/1541-6577.28.2.162 ◽

2014 ◽

Vol 28 (2) ◽

pp. 162-192 ◽

Cited By ~ 8

Author(s):

Janice L. Palmer ◽

Joanne C. Langan ◽

Jean Krampe ◽

Mary Krieger ◽

Rebecca A. Lorenz ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Nursing Home ◽

Health Care Providers ◽

Functional Disability ◽

Nursing Home Placement ◽

Nursing Home Care ◽

Multiple Chronic Conditions ◽

Care Providers ◽

Home Placement

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

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Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study

Pain Medicine ◽

10.1093/pm/pny263 ◽

2018 ◽

Vol 20 (9) ◽

pp. 1702-1710 ◽

Cited By ~ 4

Author(s):

Keitaro Makino ◽

Sangyoon Lee ◽

Sungchul Lee ◽

Seongryu Bae ◽

Songee Jung ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Functional Disability ◽

Community Dwelling ◽

Daily Physical Activity ◽

Activity Duration ◽

Intensity Physical Activity ◽

Physical Activity Duration ◽

Community Dwelling Older Adults

Abstract Objective This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. Design Prospective cohort study. Setting Japanese community. Subjects Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. Methods Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. Results Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02–3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16–3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97–3.05). Conclusions Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.

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