Impact of physical, cognitive, and psychological functions on incident homebound status after discharge among hospitalized older patients: A clinical-based prospective study

• Published in: Archives of gerontology and geriatrics 2021-01, Vol.92, p.104258-104258, Article 104258
• Main Authors: Koyama, Shingo, Komatsu, Takuma, Ishiyama, Daisuke, Suzuki, Mizue, Kimura, Yosuke, Otobe, Yuhei, Taguchi, Ryota, Shino, Shuhei, Yamada, Minoru, Yamatoku, Masato
• Format: Article
• Language: English
• Subjects: Aged; Cognition; Cognitive function; Hand Strength; Homebound; Homebound Persons; Hospitalized older patients; Humans; Patient Discharge; Physical function; Prospective Studies; Psychological function
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2020.104258

•12.9 % of hospitalized older patients were incidence of homebound status after discharge.•Locomotive functions were significantly associated with the incidence of homebound status.•Handgrip strength, MMSE, and GDS-5 were not significantly associated with the incidence of homebound status. Physical and cognitive/psychological functions are risk factors for incident homebound status. However, there are only a few studies exploring the factors related to homebound status in hospitalized older patients. The aim of this study was to determine the relationship between physical, and cognitive/psychological function at discharge among hospitalized older patients and the risk of undergoing homebound status after discharge. We analyzed the cohort data of hospitalized older patients (age ≥65 years) with internal medical problems. The main outcome was the incidence of homebound status a month after discharge. Physical functions were measured by handgrip strength (HG), knee extension strength (KES), one-leg stance (OLS), and walking speed (WS). Cognitive and psychological functions were assessed using the Mini-Mental State Examination (MMSE) and Geriatric Depression Scale-5 (GDS-5), respectively. Poisson regression models were used to estimate the risk ratios (RR) and 95 % confidence intervals (CIs) of the relationships between physical, cognitive, and psychological functions as well as the homebound status. A total of 178 participants who completed the follow-up were analyzed mean age (standard deviation) 76.2 (6.9) years. A month after discharge, 23 participants were deemed homebound, for a cumulative incidence (95 %CI) of 12.9 % (8.0 %–17.8 %). The RR (95 %CI) estimated by Poisson regression were 3.51 (1.30–9.48), 0.15 (0.03-0.72) and 0.11 (0.01-0.92) for low KES, maximum WS and comfortable WS, respectively. However, HG, OLS, MMSE, and GDS-5 were not significantly associated with the incidence of homebound status. Physical functions can predict the incidence of homebound status after discharge among hospitalized older patients.