Associations of Homebound State in Older Adults With Neighborhood Social Cohesion

Using data from the 2022-2023 U.S. National Health and Aging Trends Study, we examined the associations between neighborhood social cohesion (NSC) and homebound state (i.e., never/rarely went outside in the past month) in 2022 (N = 5,593), and between changes in NSC and changes in the homebound state between 2022 and 2023 (N = 4,907). In 2022, 4.9% of the study population were homebound, and higher perceived NSC was associated with lower odds of a homebound state (aOR = 0.79, 95% CI = 0.73-0.86, compared to 5+ times weekly outings), controlling for social support network size, neighborhood physical disorder, and sociodemographic and health characteristics. Between 2022 and 2023, 2.2% transitioned out of the homebound state, but 4.3% remained homebound or became newly homebound. Favorable changes in NSC were associated with higher odds (RRR = 1.63, 95% CI = 1.01-2.62) of recovery from homebound state the following year. These findings have important implications for considering interventions to increase social capital for older adults.