[Changes in homebound status and related factors in community-dwelling older adults participating in physical...

Objective　This study aims to identify changes in homebound status and related factors in community-dwelling older adults participating in physical checkups over two years in order to help with prevention and recovery from being homebound.Methods　A survey on needs in the sphere of daily life was conducted in July 2011 among 6,696 independent older adults in 10 regions of Kameoka City (baseline survey). Of the 6,696 adults, 1,379 responded to the survey and participated in a physical checkup held between March and April 2012. These individuals were then invited to a similar checkup again in September 2013. Of these, 638 consenting individuals were administered a questionnaire survey (follow-up survey). In all, 522 subjects responded to both surveys (baseline and follow-up) regarding being homebound. The responses involved basic attributes, state of daily living, state of health, items of the Kihon Checklist, items concerning daily living activities in the baseline survey, and items concerning being homebound in the follow-up survey. The responses were analyzed, and an evaluation of homebound status was conducted based on whether or not one (or both) of the two items of the Kihon Checklist were applicable. The subjects were classified according to the following: 1) whether non-homebound individuals remained non-homebound (non-homebound group) or whether they became homebound (homebound transition group) and 2) whether individuals who became homebound recovered (recovery group) or remained the same (persisting group). After comparing the characteristics of each group, a logistic regression analysis was employed to analyze the factors related to changes in homebound status after two years.Results　Of the 375 non-homebound individuals in the baseline survey, 326 (86.9%) and 49 (13.1%) were classified into non-homebound and homebound transition groups, respectively. Of the 147 subjects who became homebound, 85 (57.8%) and 62 (42.2%) were classified into the recovery and persisting groups, respectively.　Among the factors related to change in homebound status after two years, a low score of social role (OR=0.675, CI=0.458-0.997) was an independent factor for being at risk of becoming homebound (P<0.05). Having no diseases under treatment (OR=14.340, CI=1.345-152.944) and a high intellectual activity score (OR=2.643, CI=1.378-5.069) were independent factors of recovery from being homebound (P<0.05).Conclusion　The results of the two year longitudinal study suggest the need for support for non-homebound older individuals devoid of social roles to prevent homebound status. Additionally, there is a need for support surrounding the reduction in obtaining a disease and maintaining intellectual activity in order to recover from being homebound.