TY - JOUR
T1 - Social isolation, homebound status, and race among older adults
T2 - Findings from the National Health and Aging Trends Study (2011–2019)
AU - Cudjoe, Thomas K.M.
AU - Prichett, Laura
AU - Szanton, Sarah L.
AU - Roberts Lavigne, Laken C.
AU - Thorpe, Roland J.
N1 - Funding Information:
The authors thank their patients for always being a source of inspiration, Shang-En Chung, JHU BEAD Core, and for the Johns Hopkins Editorial Assistance Services Initiative.
Funding Information:
Dr. Cudjoe was supported by the Research Supplements to Promote Diversity in Health‐Related Research Program (Johns Hopkins Roybal Center‐3P30AG048773‐03S1), Secunda Family Foundation, the National Institute on Aging Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR‐R03AG064253), and as a Caryl & George Bernstein Human Aging Project Scholar in the Johns Hopkins University Center for Innovative Medicine. Roland J. Thorpe, Jr.’s research was supported by the National Institute on Aging (K02AG059140; R01AG054363) and the National Institute on Minority Health and Health Disparities (U54MD000214). Laken Roberts Lavigne was supported by the National Heart, Lung, and Blood Institute (F31 HL146080). Funding information
Publisher Copyright:
© 2022 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.
PY - 2022/7
Y1 - 2022/7
N2 - Background: Multiple factors may influence the risk of being homebound, including social isolation and race. This study examines the relationship between social isolation and homebound status by race over 9 years in a sample of adults. Methods: Utilizing a representative sample of 7788 Medicare beneficiaries aged 65+ from 2011–2019, we assessed the odds of becoming homebound by social isolation. We defined social isolation as the objective lack of contact with others. We defined severe social isolation as scoring a 0 or 1 on a social connection scale from 0 to 4. Homebound status was defined as never leaving home or only leaving home with difficulty. Utilizing a multivariate Cox proportional hazards model adjusting for age, gender, marital status, income, and education, we examined the association between social isolation at baseline and becoming homebound during the study in those who were not initially homebound. Results: Older adults in this study were on average 78 years old. Overall, most were white (69%), female (56.3%), and married (57.8%) and reported that they had a college education or higher (43.9%). Also, at baseline, approximately 25% of study participants were socially isolated, 21% were homebound, and 6.3% were homebound and socially isolated or severely socially isolated. Homebound status at baseline varied by race: Black, 23.9% and white, 16.6% (p < 0.0001). After 9 years, socially isolated black (hazard risk ratio, HRR 1.35, 95% confidence interval CI [1.05,1.73], p < 0.05) and white (HRR 1.25, 95% CI [1.09,1.42], p < 0.01) older adults were at higher risk of becoming homebound. Conclusion: Socially isolated black and white adults are more likely to be homebound at baseline and become homebound over time. Further research is needed to determine whether community-based strategies and policies that identify and address social isolation reduce homebound status among community-dwelling older adults.
AB - Background: Multiple factors may influence the risk of being homebound, including social isolation and race. This study examines the relationship between social isolation and homebound status by race over 9 years in a sample of adults. Methods: Utilizing a representative sample of 7788 Medicare beneficiaries aged 65+ from 2011–2019, we assessed the odds of becoming homebound by social isolation. We defined social isolation as the objective lack of contact with others. We defined severe social isolation as scoring a 0 or 1 on a social connection scale from 0 to 4. Homebound status was defined as never leaving home or only leaving home with difficulty. Utilizing a multivariate Cox proportional hazards model adjusting for age, gender, marital status, income, and education, we examined the association between social isolation at baseline and becoming homebound during the study in those who were not initially homebound. Results: Older adults in this study were on average 78 years old. Overall, most were white (69%), female (56.3%), and married (57.8%) and reported that they had a college education or higher (43.9%). Also, at baseline, approximately 25% of study participants were socially isolated, 21% were homebound, and 6.3% were homebound and socially isolated or severely socially isolated. Homebound status at baseline varied by race: Black, 23.9% and white, 16.6% (p < 0.0001). After 9 years, socially isolated black (hazard risk ratio, HRR 1.35, 95% confidence interval CI [1.05,1.73], p < 0.05) and white (HRR 1.25, 95% CI [1.09,1.42], p < 0.01) older adults were at higher risk of becoming homebound. Conclusion: Socially isolated black and white adults are more likely to be homebound at baseline and become homebound over time. Further research is needed to determine whether community-based strategies and policies that identify and address social isolation reduce homebound status among community-dwelling older adults.
KW - National Health and Aging Trends Study
KW - homebound
KW - race
KW - social connection
KW - social isolation
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U2 - 10.1111/jgs.17795
DO - 10.1111/jgs.17795
M3 - Article
C2 - 35415872
AN - SCOPUS:85128066350
SN - 0002-8614
VL - 70
SP - 2093
EP - 2100
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 7
ER -