Risks and Outcomes of New Onset of Unmet Need for Mobility and Self-Care Daily Activities

Among community-living older adults who have limitations in completing activities of daily living (ADLs), unmet need occurs when they cannot complete an ADL task because no one was available to help. Prior research described correlates of existing unmet needs but did not consider which older adults are at risk for new onset of unmet needs. This study assessed health characteristics that increased risk for new onset of unmet needs within a year and subsequent health outcomes.

Data are from 2011 to 2019 annual interviews of the National Health and Aging Trends Study. For each pair of 2 consecutive annual interviews, we determined whether new onset of unmet needs occurred between the first and second consecutive interviews. Mixed effects logistic regression models were computed to assess risks for new onset of unmet need across 14,890 paired observations from persons who needed help with mobility tasks and 12,514 paired observations from persons who needed help with self-care tasks.

Although demographic characteristics and chronic conditions had modest associations with new onset of unmet need, hospitalization between the 2 consecutive interviews was associated with a twofold increase in risk for new onset of unmet need. New onset of unmet need was associated with hospitalization, nursing home placement, and death in the year following the 2 consecutive annual interviews.

The findings inform the need for frequent assessments of ADL care needs with the goal of preventing new onset of unmet needs, especially after hospitalization.