Homebound status increases death risk within two years in the elderly: results from a national longitudinal survey

Homebound status is associated with poorer physical and mental health, as well as disability in the elderly. We aimed to examine the prevalence and the role of homebound status on mortality in a representative sample of the French non-institutionalized population. This study included 7497 people aged 65 and over who were interviewed in 1999 and 2001 about the consequences of health problems on activities of daily living. Homebound status was defined as staying permanently inside the home, excluding an accident or a temporary illness. The influence of the homebound status on two-year mortality was assessed in a logistic regression model adjusted for the main confounders (age, sex, living as a couple, physical and mental impairments). The prevalence of homebound status was 4.7% (95% CI: 3.9-5.4) in this study. The number of homebound elderly was estimated at 421000 in France. The prevalence of homebound status increases with age and reaches 33.9% in people aged 95-99 years (95% CI: 13.1-54.6). Compared to non-homebound subjects, homebound elderly were more likely to be female, widower, to live alone and to have had a former low level job. Homebound status was associated with a number of physical and mental impairments. It increased the risk of dying within two years with an adjusted OR 3.45 (95% CI: 2.66-4.46). Homebound status should be considered as an indicator of frailty and used in the identification of old people likely to benefit from preventive interventions.