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Aging Ment Health. 2019 Aug 7:1-10. doi: 10.1080/13607863.2019.1650888. [Epub ahead of print]

Influence of senior housing types on cognitive decline and nursing home admission among lower-income older adults.

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a George Warren Brown School of Social Work, Washington University in Saint Louis , Saint Louis, MO , USA.
b College of Health and Human Services, University of New Hampshire , Durham , NH , USA.
c Department of Social Work, St. Cloud State University , St. Cloud , MN , USA.


Objectives: Focusing on unique ageing populations in subsidized senior housing for lower-income older adults, this study contributes to literature on housing and aging; provides initial understanding of existing housing types; and explores the extent to which living in different housing types may influence changes in cognitive function and likelihood of nursing home admission. Method: Data came from seven waves (2002-2014) of the Health and Retirement Study. A latent-class clustering approach was used to identify senior-housing types among lower-income older people; Results: We identified four discernible housing types among lower-income older adults: (1) High physical & Low service, (2) Low physical & Low service, (3) High physical & High service, and (4) Medium physical & High service. Individuals in Medium physical & High service and High physical & Low service types were likely to have higher cognitive-function levels at baseline (B = 0.58, p < .001; 0.58, p < .001) and slower rates of decline over time (B = 0.42, p < .001; B = 0.32, p < .01). Older adults in High physical & High service are significantly less likely to be admitted to a nursing home (OR = 0.55, p < .00). Conclusion: The mismatch between health needs and lack of service and support suggests that current residents in each housing type relocate, based on knowledge of subsidized housing or availability. Future studies should examine possible mismatches between health needs and housing environment.


Support levels in senior housing; cognitive decline; lower-income older people; nursing home admission

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