Examining Older Adults' Home Functioning Using the American Housing Survey

Area of Science:

• Gerontology
• Public Health
• Housing Studies

Background:

• Identifying functional difficulty in older adults is crucial for proactive home safety interventions.
• Falls and home incidents among the elderly necessitate effective assessment tools.
• Existing measures may not fully capture the nuances of functional limitations within the home environment.

Purpose of the Study:

• To develop and validate a scoring system for functional difficulty at home among older adults.
• To utilize the 12 physical function items from the American Housing Survey (AHS) for this purpose.
• To establish a reliable measure for identifying at-risk individuals for home safety interventions.

Main Methods:

• Employed confirmatory factor analysis (CFA) to assess a one-dimensional model of functional difficulty.
• Utilized the Graded Response Model (GRM) for item response theory analysis.
• Validated the measurement model using a large dataset (N=28,474) split for development and testing.

Main Results:

• The one-dimensional model demonstrated an adequate fit (RMSEA: 0.034, CFI: 0.990, TLI: 0.988).
• The GRM proved optimal, identifying and adjusting for differential item functioning by sex.
• Validated scores exhibited expected item hierarchy and significant associations with housing and demographic factors (p < 0.001).

Conclusions:

• The 12 AHS physical function items can effectively generate validated scores for older adults' functional difficulty at home.
• This scoring method provides a valuable tool for identifying individuals at risk of functional decline.
• Findings support the implementation of targeted home safety assessments and modifications to reduce incidents like falls.