Prevalence of and factors associated with homebound status among adults in urban and rural Spanish populations

Autor: Laureano Negrón-Blanco, Jesús de Pedro-Cuesta, Javier Almazán, Carmen Rodríguez-Blázquez, Esther Franco, Javier Damián, on behalf of the DISCAP-ARAGON Research Group
Přispěvatelé: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red - CIBERNED (Enfermedades Neurodegenerativas), Fundación Farasdués
Jazyk: angličtina
Předmět:
Male
Rural Population
Gerontology
Social Work
Urban Population
Cross-sectional study
Population
Poison control
Comorbidity
Severity of Illness Index
Homebound Persons
03 medical and health sciences
0302 clinical medicine
Homebound status
International Classification of Functioning
Disability and Health
Severity of illness
Prevalence
Humans
Medicine
Disabled Persons
030212 general & internal medicine
Sex Distribution
education
Dependence
Aged
Aged
80 and over
education.field_of_study
Disability
business.industry
lcsh:Public aspects of medicine
Incidence (epidemiology)
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Odds ratio
Health Services
Middle Aged
Ageing
Cross-Sectional Studies
Mental Health
Socioeconomic Factors
Spain
Female
Older people
Cognition Disorders
business
030217 neurology & neurosurgery
Research Article
Zdroj: Repisalud
Instituto de Salud Carlos III (ISCIII)
BMC Public Health, Vol 16, Iss 1, Pp 1-11 (2016)
BMC Public Health
ISSN: 1471-2458
DOI: 10.1186/s12889-016-3270-z
Popis: BACKGROUND: There is a marked growth in the number of homebound older adults, due mainly to increased life expectancy. Although this group has special characteristics and needs, it has not been properly studied. This study thus aimed to measure the prevalence of homebound status in a community-dwelling population, and its association with both socio-demographic, medical and functional characteristics and the use of health care and social services. METHODS: We used instruments coming under the WHO International Classification of Functioning (ICF) framework to carry out a cross-sectional study on populations aged 50 years and over in the province of Zaragoza (Spain), covering a total of 1622 participants. Persons who reported severe or extreme difficulty in getting out of the house in the last 30 days were deemed to be homebound. We studied associations between homebound status and several relevant variables in a group of 790 subjects who tested positive to the WHODAS-12 disability screening tool. RESULTS: Prevalence of homebound status was 9.8 % (95 % CI: 8.4 to 11.3 %). Homebound participants tended to be older, female and display a lower educational level, a higher number of diseases, poorer cognition and a higher degree of disability. In fully adjusted models including disability as measured with the ICF-Checklist, the associated variables (odds ratios and [95 % confidence intervals]) were: female gender (3.75 [2.10-6.68]); urban population (2.36 [1.30-4.29]); WHODAS-12 disability (6.27 [2.56-15.40]); depressive symptoms (2.95 [1.86-4.68]); moderate pain (2.37 [1.30-4.31] and severe pain (3.03 [1.31-7.01]), as compared to the group with no/mild pain; hospital admissions in the previous 3 months (2.98 [1.25-7.11]); and diabetes (1.87 [1.03-3.41]). Adjustment for ICF-Checklist disability had a notable impact on most associations. CONCLUSIONS: The study shows that homebound status is a common problem in our setting, and that being disabled is its main determinant. Socio-demographic characteristics, barriers and chronic diseases can also be assumed to be playing a role in the onset of this condition, indicating the need for further research, including longitudinal studies on its incidence and associated factors. This study was funded by the Carlos III Institute of Health (projects EPI 1637–1606 and 1530–1507), Health Research Fund (Fondo de Investigaciones Sanitarias/FIS grants PI06/1098 and PI 07/90206), Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas/CIBERNED), Zaragoza Provincial Authority, and the Farasdués Foundation. Sí
Databáze: OpenAIRE
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