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Variation in Response to a Home Intervention to Support Daily Function by Age, Race, Sex, and Education
Journal article   Open access   Peer reviewed

Variation in Response to a Home Intervention to Support Daily Function by Age, Race, Sex, and Education

Laura N. Gitlin, Laraine Winter, Marie P. Dennis and Walter W. Hauck
The journals of gerontology. Series A, Biological sciences and medical sciences, v 63(7), pp 745-750
Jul 2008
DOI: https://doi.org/10.1093/gerona/63.7.745
PMID: 18693230
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://academic.oup.com/biomedgerontology/article-pdf/63/7/745/2294414/745.pdfView
Published, Version of Record (VoR) Open
url
https://doi.org/10.1093/gerona/63.7.745View
Published, Version of Record (VoR) Open

Abstract

Disability Frailty Home modification
Background. Functional difficulty is associated with increased frailty and poor life quality, with the oldest old, women, African Americans, and less educated persons at greatest risk of disablement. This study examines whether these at-risk groups benefit differentially from an in-home intervention previously found to effectively reduce functional difficulties. Methods. Three hundred nineteen community-living, functionally vulnerable adults 70 years old or older were randomized to usual care or an intervention involving occupational and physical therapy home instruction in problem solving, device use, energy conservation, safety, fall recovery, balance, and muscle strengthening. Outcome measures at 6 and 12 months included difficulty level in ambulation, instrumental (IADLs) and activities of daily living (ADLs), self-efficacy, and fear of falling. Results. At 6 months, for ADLs, individuals ≥80 years (p =.022), women (p =.036), and less educated persons (p =.028) improved compared to their control group counterparts. For mobility, women (p =.048) and the oldest participants (p =.001) improved relative to their counterparts. For self-efficacy, women (p =.036) benefited more than men. For fear of falling, less educated persons improved more than their counterparts (p =.001). A similar pattern was found at 12 months. For IADLs, whites improved more than non-whites at 12 months. Conclusions. Treatment benefits varied by specific participant characteristics, with individuals at greatest disability risk being most responsive to the intervention. Both white and minority participants benefited similarly except in IADL functioning. Future research should control for participant characteristics, identify underlying mechanisms for variation in treatment effects, and tailor treatment to patient characteristics and desired outcomes.

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38 citations in Web of Science
45 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality
#3 Good Health and Well-Being
#2 Zero Hunger

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Web of Science research areas
Geriatrics & Gerontology
Gerontology
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