Supportive Environmental Features at Home as Proactive/Reactive Associates of Disability and Mortality Status in Older Adults

Supportive environmental features (SEFs) are attributes of homes that help people overcome activity limitations. Evidence suggests that SEFs may facilitate aging in place. However, real-life SEF implementation patterns are not fully understood. This study examined associations between SEFs and disability/mortality status. We analyzed the first cohort of the National Health and Aging Trends Study using multinomial logistic regression. SEFs were operationalized using indicators of home accessibility, including bathroom home modifications (BHMs) and supportive housing features (SHFs). Basic activities of daily living (ADL) and instrumental ADLs (IADL) were used to quantify disability status. Changed SEF status and disability status, combined with mortality, served as dependent variables. At baseline, BHM/SHF did not predict changes in disability. Disability burden predicted lower likelihood of SEF addition. Greater baseline SEF predicted future additions of SEFs. Raising awareness of SEF in the context of increasing ADL/IADL limitations is key to promoting SEF implementation among older adults.