Disability Levels and Correlates among Older Mobile Home Dwellers, an NHATS analysis

1. Disability Levels and Correlates among Older Mobile Home Dwellers, an NHATS analysis Tala M. Al-Rousan, Linda M. Rubenstein, Robert B. Wallace College of Public Health, Department of epidemiology Results Table 1. Respondent Characteristics: 2011 NHATS community-dwelling residents (N=7609) Table 2. Linear regression results of weighted prevalence of home environmental modifications among the NHATS 2011 cohort reporting disability Introduction • The unprecedented demographic shift estimated to increase the proportion of American older adults to 20% in 20501 creates strains on the ability to accommodate the housing needs of an aging population. • Given that a significant amount of their time is spent at home,2,3 analyzing the housing situation in relation to older adults’ health conditions is a public health priority. • Although remarkably understudied, manufactured or mobile homes are the housing choice for nearly 20 million Americans and constitute 10–20% of all new housing production. ,3 A Responded unable/need help in at least one of the 11 following activities walking 3 blocks, getting in and out of bed bathing, dressing, eating, using the toilet, preparing hot meals, shopping, money management, medication management and using the phone B Weighted p-values and ORs (95% CI) adjusted for age, education, gender, and income. 88.3% 82.9% p= 0.07 p= 0.002 Methods 33.5% 40.8% p= 0.002 37.7% 36.5% 31.7% 23.5% 26.3% We sampled non-institutional adults aged 65 years or older (n = 7609), of whom 344 lived in mobile homes, from the 2011 National Health and Aging Trends Study (NHATS), a nationally representative sample of adults age 65 or older, derived from Medicare rolls. We performed multivariate analysis to study interactions between disability levels and environmental modifications. 34.8% p= 0.002 39.2% 41.5% p= 0.001 46.5% 60.8% 64.9% p= 0.007 Conclusion There is evidence for increased risk of chronic conditions, functional disability, and cognitive impairment in older mobile home dwellers compared to older adults living in other types of housing. This calls for increased public health and clinical attention to problems such as clinical detection and environmental adaptation of these residences. Discussion To our knowledge, the effect of mobile homes or other general types of housing on the onset or progression of disability has not been systematically studied. We found in this nationally-representative sample, that respondents living in mobile homes, despite being younger than their counterparts in other community housing types, had higher prevalence rates for functional disability as well lower cognitive scores on selected test items. The inability to perform basic ADLs, particularly those related to ambulation, was demonstrated. While this finding is derived from cross-sectional data, if further difficulty or corroborated, this finding could be of value to both clinicians evaluating and managing disability among older person, and to public health professionals concerned with housing quality and appropriate rehabilitation. References Vincent GK, Velkoff VA. The next four decades: The older population in the United States: 2010 to 2050. US Department of Commerce, Economics and Statistics Administration, US Census Bureau; 2010. 2.Middleton LE, Manini TM, Simonsick EM, et al. Activity energy expenditure and incident cognitive impairment in older adults. Archives of Internal Medicine. 2011;171(14):1251-1257. 3.Thorp AA, Owen N, Neuhaus M, Dunstan DW. Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996–2011. American journal of preventive medicine. 2011;41(2):207-215.