Characteristics of rural homebound older adults: a community-based study

J Am Geriatr Soc. 1996 Apr;44(4):363-70. doi: 10.1111/j.1532-5415.1996.tb06403.x.


Objective: To determine the frequency and characteristics of homebound older adults in a rural community.

Design: An epidemiological survey of an age-stratified random community sample.

Setting: The rural mid-Monongahela Valley in Southwestern Pennsylvania.

Participants: A total of 878 noninstitutionalized persons aged 68 years and older, fluent in English, and with at least grade 6 education.

Measurements: The frequency with which subjects left their homes, the Mini-Mental State Examination (MMSE) score, and additional information on demographics, self-reported health problems, health services utilization, IADLs, depression, and social support were measured.

Results: 10.3% of the sample was classified as homebound. In univariate analyses, being homebound was found to be associated significantly (P < .001) with being older, female, and widowed and with MMSE and IADL impairment, with more depressive symptoms and worse social supports, fair to poor self-rated general health, weight loss, and histories of stroke, angina, arthritis of the spine, and falls. In a multiple regression model, variables associated independently with homebound status were gender (odds ratio = 9.4, 95% confidence interval = 3.6 - 24.9), weight loss (OR = 3.7, CI = 1.7 - 8.2), IADL impairment (OR = 2.6, CI = 2.1 - 3.1), and depressive symptoms (OR = 2.1, CI = 1.3 - 3.2). Being homebound was also associated with recent acute hospitalization and use of home health and social services.

Conclusions: These data provide evidence that homebound older adults have a disproportionate share of morbidity and disability and suggest a sociodemographic and clinical profile to help identify those older people at risk of being or becoming homebound. They also point to the need for home-based health services for the older adults, particularly in medically underserved communities such as rural areas.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cohort Studies
  • Female
  • Homebound Persons* / statistics & numerical data
  • Humans
  • Interviews as Topic / methods
  • Male
  • Medically Underserved Area
  • Pennsylvania
  • Rural Population* / statistics & numerical data
  • Social Support
  • Socioeconomic Factors