{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:10:44Z","timestamp":1787587844239,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T00:00:00Z","timestamp":1552435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Michigan Older Americans Independence Center Research Education Core","award":["AG024824"],"award-info":[{"award-number":["AG024824"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>The purpose of this study was to examine the trajectories of homebound status in older adults and to investigate the risk factors in shaping the pattern of these trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>The study sample was a nationally representative sample of Medicare beneficiaries aged 65 and older (N = 7,607) from the National Health and Aging Trends Study (Round 1\u2013Round 7). Homebound state was defined as never or rarely went out the home in the last month. Homebound trajectories were identified using an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression was used to examine risk factors of homebound trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three trajectory groups were identified: the \u201cnever\u201d group (65.5%) remained nonhomebound; the \u201cchronic\u201d group were largely persistently homebound (8.3%); and the \u201conset\u201d group (26.2%) had a rapid increase in their risk of being homebound over the 7-year period. The following factors increased the relative risk for being on the \u201conset\u201d and \u201cchronic\u201d versus the \u201cnever\u201d trajectory: older age, Hispanic ethnicity, social isolation, past or current smoking, instrumental activities of daily living limitations, probable dementia, and use of a walker or wheelchair. Male sex and living alone were associated with a lower risk of being on the \u201cchronic\u201d trajectory, whereas depression and anxiety symptoms, chronic conditions, and activities of daily living limitations increased the risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>The progression of homebound status among community-dwelling older adults followed three distinct trajectories over a 7-year period. Addressing social isolation and other risk factors may prevent or delay the progression to homebound state.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geront\/gnz023","type":"journal-article","created":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T23:21:27Z","timestamp":1550445687000},"page":"101-111","source":"Crossref","is-referenced-by-count":49,"title":["Trajectories of Homebound Status in Medicare Beneficiaries Aged 65 and Older"],"prefix":"10.1093","volume":"60","author":[{"given":"Xiaoling","family":"Xiang","sequence":"first","affiliation":[{"name":"School of Social Work, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieling","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, 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