Family structure is linked to homeboundness transitions
In NHATS data from 2011 to 2024, 23.6% of homebound adults returned to independence, while being unpartnered was linked to higher nursing home and mortality risks.
The Journals of Gerontology, Series B
Using data from the National Health and Aging Trends Study from 2011 to 2024, researchers tracked transitions between independence, homeboundness, nursing home residence, and death among older adults in the United States. Among independent respondents, 84.6% remained independent, while 12.2% became homebound by the subsequent wave. Among those who were homebound, 60.1% remained homebound, 23.6% returned to independence, 2.4% entered a nursing home, and 13.9% died. Family structure was associated with these transitions. Unpartnered older adults had higher risks of moving from independence to a nursing home (relative risk ratio = 1.752) and death (RRR = 1.265). Compared to childless peers, parents had lower risks of transitioning from independence to a nursing home (RRR = 0.523) and death (RRR = 0.735), and from homeboundness to a nursing home (RRR = 0.574). The link between being unpartnered and becoming homebound was significantly stronger among men than women.
Why it matters
The findings highlight that homeboundness in late life is a dynamic and potentially reversible state. They also suggest that social ties and family arrangements may shape late-life functional trajectories and the capacity to age in place.
Caveats
The analysis relied on observational survey data, which cannot determine whether family structure directly alters transition risks. Additionally, homebound status was categorized based on reported difficulty or assistance needed when leaving home rather than objective clinical evaluations.
The paper
Texas State University
The Journals of Gerontology, Series B · 1 Oct 2026