# Associations of Homebound State in Older Adults With Neighborhood Social Cohesion

## TL;DR

Higher neighborhood social cohesion is linked to fewer older adults being homebound and better chances of recovering from being homebound.

## Contribution

This study identifies a novel association between neighborhood social cohesion and transitions in/out of a homebound state among older adults.

## Key findings

- Higher perceived neighborhood social cohesion is associated with lower odds of being homebound.
- Improvements in neighborhood social cohesion are linked to increased odds of recovering from a homebound state.
- A small proportion of homebound individuals transitioned out of the state between 2022 and 2023.

## Abstract

Using data from the 2022-2023 U.S. National Health and Aging Trends Study, we examined the associations between neighborhood social cohesion (NSC) and homebound state (i.e., never/rarely went outside in the past month) in 2022 (N = 5,593), and between changes in NSC and changes in the homebound state between 2022 and 2023 (N = 4,907). In 2022, 4.9% of the study population were homebound, and higher perceived NSC was associated with lower odds of a homebound state (aOR = 0.79, 95% CI = 0.73-0.86, compared to 5+ times weekly outings), controlling for social support network size, neighborhood physical disorder, and sociodemographic and health characteristics. Between 2022 and 2023, 2.2% transitioned out of the homebound state, but 4.3% remained homebound or became newly homebound. Favorable changes in NSC were associated with higher odds (RRR = 1.63, 95% CI = 1.01-2.62) of recovery from homebound state the following year. These findings have important implications for considering interventions to increase social capital for older adults.