Depressive tendencies and negative life events as predictors of homebound status among older adults in japan

Abstract This study aimed to examine negative life events (NLEs) and depressive tendencies as predictors of homebound status, which poses a risk of long-term frailty in older adults. A population-based cohort study (2018-2020) using self-administered questionnaires was conducted with older adults (65-94 years) in the rural community of Akita Prefecture, Japan. The response rate at the baseline survey in 2018(T1) was 61.5%. About 81.1% (1,048 out of 1,291) of the participants at T1 responded to the follow-up survey in 2020 (T2). Among them, 77.3% (810) were not homebound at T1. After data cleaning, 790 participants’ data were analyzed. A frequency of going out less than once a week was considered a homebound status. In this study, NLEs included 1) loss of a close relative, 2) major illness or injury to oneself, 3) major illness or injury to a family member, 4) financial difficulties, and 5) loss of one’s role (family, workplace, society, others). Depressive tendencies were evaluated using the 6-item Kessler Psychological Distress Scale (0-24 scale). A K6 score ≥ 9 indicates depressive tendencies. Logistic regression analysis was adjusted for potential confounders. The incidence of being homebound at two years was 10.1% for men and 17.1% for women, with a significant gender difference (p< 0.01). The adjusted odds ratio for depressive tendencies was 3.37 (95%CI= 1.62-7.01) among homebound (vs. non-homebound) individuals. However, the five NLEs were not statistically significant. Our results suggest that depressive tendencies, but not NLEs, can cause older adults to remain housebound.