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J Am Geriatr Soc. 2018 Jan;66(1):106-112. doi: 10.1111/jgs.15148. Epub 2017 Nov 22.

Frequency of Leaving the House and Mortality from Age 70 to 95.

Author information

1
Jerusalem Institute of Aging Research, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, Israel.
2
Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, Israel.

Abstract

OBJECTIVES:

To determine the association between frequency of leaving the house and mortality.

DESIGN:

Prospective follow-up of an age-homogenous, representative, community-dwelling birth cohort (born 1920-21) from the Jerusalem Longitudinal Study (1990-2015).

SETTING:

Home.

PARTICIPANTS:

Individuals aged 70 (n = 593), 78 (n = 973), 85 (n = 1164), and 90 (n = 645), examined in 1990, 1998, 2005, and 2010, respectively.

MEASUREMENTS:

Frequency of leaving the house, defined as daily (6-7/week), often (2-5/week), and rarely (≤1/week); geriatric assessment; all-cause mortality (2010-15). Kaplan-Meier survival charts and proportional hazards models adjusted for social (sex, marital status, financial status, loneliness), functional (sex, self-rated health, fatigue, depression, physical activity, activity of daily living difficulty), and medical (sex, chronic pain, visual impairment, hearing impairment, diabetes mellitus, hypertension, ischemic heart disease, chronic kidney disease) covariates.

RESULTS:

At ages 70, 78, 85, and 90, frequency of going out daily was 87.0%, 80.6%, 65.6%, and 48.4%; often was 6.4%, 9.5%, 17.4%, and 11.3%; and rarely was 6.6%, 10.0%, 17.0%, and 40.3% respectively. Decreasing frequency of going out was associated with negative social, functional, and medical characteristics. Survival rates were lowest among those leaving rarely and highest among those going out daily throughout follow-up. Similarly, compared with rarely leaving the house, unadjusted mortality hazard ratios (HRs) were lowest among subjects leaving daily and remained significant after adjustment for social, functional and medical covariates. Among subjects leaving often, unadjusted HRs showed a similar effect of smaller magnitude, with attenuation of significance after adjustment in certain models. Findings were unchanged after excluding subjects dying within 6 months of follow-up.

CONCLUSION:

In community-dwelling elderly adults aged 70 to 90, leaving the house daily was associated with lower mortality risk, independent of social, functional, or medical status.

KEYWORDS:

leaving the house; mortality; oldest old; survival

PMID:
29164595
DOI:
10.1111/jgs.15148

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