Associations Between Visual Impairment and Homebound Status, Home Hazards, and Support Service Utilization: The...

Area of Science:

• Gerontology and Public Health
• Ophthalmology and Vision Science
• Health Services Research

Background:

• Visual impairment (VI) is a growing concern among older adults, potentially impacting their independence and safety.
• Understanding the relationship between VI and homebound status, home hazards, and long-term services and supports (LTSS) is critical for targeted interventions.

Purpose of the Study:

• To investigate the association between visual impairment (VI) and homebound status in older adults.
• To examine the link between VI and the presence of home safety hazards.
• To assess the relationship between VI and the utilization of home-based long-term services and supports (LTSS).

Main Methods:

• Longitudinal and cross-sectional analyses were conducted using National Health and Aging Trends Study (NHATS) data from 2021-2023.
• The study included 3,022 Medicare beneficiaries aged 71 years and older.
• Visual impairment was defined by specific criteria for visual acuity and contrast sensitivity. Homebound status, home hazards, and LTSS utilization were assessed using established definitions and in-home evaluations.

Main Results:

• Visual impairment was significantly associated with a higher likelihood of being and becoming homebound or semi-homebound (OR = 1.52, HR = 1.35).
• Participants with VI were more likely to have home safety hazards (OR = 1.88) and utilize home-based LTSS (OR = 1.35).
• The risk of homebound status increased with the severity and breadth of visual impairment.

Conclusions:

• Visual impairment is a substantial risk factor for homebound status and increased home hazards among older adults.
• Individuals with VI require more home-based LTSS, highlighting challenges in maintaining home safety and function.
• Early vision interventions, comprehensive home safety assessments, and tailored LTSS are recommended preventive strategies.