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IMPACT OF NEIGHBORHOOD RESOURCES ON HOMEBOUND STATUS
Katherine A. Ornstein, M Garrido, Albert L. Siu. Innovation in Aging, 2018-11-01
Topic: Risk, prevention and care in population studies
A growing population of individuals with multimorbidity, cognitive impairment and functional decline live in the community but are homebound, defined as rarely or never leaving home. Homebound status is associated with decreased access to medical services and poor health outcomes. The goal of this study was to understand whether neighborhood resources enabled individuals to delay homebound status and remain in the community. Using the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries, linked to the U.S. Census, Dartmouth Atlas, Area Health Resource Files (AHRF) and LTCFocus, we followed 7042 initially non-homebound community-dwelling older adults for 5 years. We used Cox Proportional Hazards Models to predict time to homebound status, censoring for death, loss to follow up and nursing home status, adjusting for NHATS analytic weights. In analyses controlling for clinical characteristics (e.g., dementia status, function) and demographic factors (e.g., individual income, education, urbanicity, caregiving resources), availability of nursing home beds and primary care providers and walkability did not impact risk of becoming homebound. High neighborhood SES was protective against homebound status, although this relationship was attenuated in fully adjusted models (HR = .80; p=.07). Those living in areas with more homecare agencies had higher hazards of becoming homebound (p<.01). Homebound status is an understudied adverse outcome for older adults that may be dependent on neighborhood resources. Understanding relationships among neighborhood characteristics and homebound risk may lead to identification of targets for interventions/policies to allow older adults to maintain independence and interaction with the community.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Ornstein, K. A., Garrido, M., & Siu, A. L. (2018). IMPACT OF NEIGHBORHOOD RESOURCES ON HOMEBOUND STATUS. Innovation in Aging. https://doi.org/10.1093/geroni/igy023.2852
Vancouver
Ornstein KA, Garrido M, Siu AL. IMPACT OF NEIGHBORHOOD RESOURCES ON HOMEBOUND STATUS. Innovation in Aging. 2018. doi:10.1093/geroni/igy023.2852.
BibTeX
@article{ornstein2018-828b8138,
author = {Ornstein, Katherine A. and Garrido, M and Siu, Albert L.},
title = {{IMPACT OF NEIGHBORHOOD RESOURCES ON HOMEBOUND STATUS}},
journal = {Innovation in Aging},
year = {2018},
doi = {10.1093/geroni/igy023.2852},
url = {https://doi.org/10.1093/geroni/igy023.2852}
}
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Key findings
- Homebound status is associated with decreased access to medical services and poor health outcomes.
Why it matters
In this study of 7042 older adults, neighborhood factors such as nursing home bed availability, primary care providers, and walkability did not affect the risk of becoming homebound. High neighborhood socioeconomic status was protective, but this relationship weakened in fully adjusted models and was not statistically significant.
Study details
- Evidence strengthLow
How this study scored 27/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Albert L. Siu: h-index 76 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Icahn School of Medicine at Mount Sinai: institution h-index 1,331 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 27 / 100 | — |
What each of these 20 components measures, and what this score is not →
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