Incidence of disability in housebound elderly people in a rural community in Japan

Background:  Although being housebound is acknowledged conceptually as a risk factor for disability and social isolation, there has been little epidemiologic research on housebound status. This study aimed to explore whether being housebound is a risk factor for disability and whether a low level of social contact increases that risk in elderly persons. Methods:  A questionnaire pertaining to demographic characteristics was administered to 2932 community-dwelling elderly persons (aged 65 years and older) in October 2000. There were 2459 responses, and 2180 respondents were independently performing activities of daily living. Of these, 2046 were followed up until March 2003. These 2046 people became the subjects of our analysis. At the end of the follow-up period, the 2046 subjects were assessed for disability. Results:  Overall, 7.5% of the subjects were housebound at baseline, and about half of these were able to leave the house unassisted, seldom did so but had social contact. At the end of the follow-up period, 12.7% of subjects were identified as disabled. The incidence of disability was higher in housebound than in non-housebound subjects aged less than 85 years but did not differ significantly among subjects aged more than 85 years. Levels of disability were higher in all housebound subjects groups than in non-housebound subjects. Subjects without social contact exhibited a higher incidence of disability than others, although the difference was not statistically significant. Conclusion:  Being housebound appears to be a risk factor for disability in community-dwelling individuals aged 65–85 years who are living independently, but a low level of social contact was not proved to be an additional risk factor for disability among housebound elderly persons.