Article

OBJECTIVE: To explore the influence of physical home and social environments and
disability patterns on nursing home (NH) use. DESIGN: Longitudinal cohort study.
Self- or proxy-reported perception of home environmental barriers accessibility,
5 stages expressing the severity and pattern of activities of daily living (ADLs)
limitations, and other characteristics at baseline were applied to predict NH use
within 2 years or prior to death through logistic regression. SETTING: General
community. PARTICIPANTS: Population-based, community-dwelling individuals
(N=7836; >/=70y) from the Second Longitudinal Study of Aging interviewed in 1994
with 2-year follow-up that was prospectively collected. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: NH use within 2 years. RESULTS: Perceptions of
home environmental barriers and living alone were both associated with
approximately 40% increased odds of NH use after adjustment for other factors.
Compared with those with no limitations at ADL stage 0, the odds of NH use peaked
for those with severe limitations at ADL stage III (odds ratio [OR]=3.12; 95%
confidence interval [CI], 2.20-4.41), then declined sharply for those with total
limitations at ADL stage IV (OR=.96; 95% CI, .33-2.81). Sensitivity analyses for
missing NH use showed similar results. CONCLUSIONS: Accessibility of home
environment, living circumstance, and ADL stage represent potentially modifiable
targets for rehabilitation interventions for decreasing NH use in the aging U.S.
population.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS