Factors Associated With Subjective Wellbeing in Community-Dwelling Homebound Older Adults With Diabetes in the US

Abstract

Background: The interplay of aging, diabetes, and homebound status introduces challenges that can substantially diminish overall well-being. Understanding the factors that influence subjective well-being in homebound older adults with diabetes is crucial for developing strategies that enhance their health and longevity. We aimed to identify independent correlates of well-being in community-dwelling homebound older adults aged 65 and older with diabetes. Methods: Using data from the National Health and Aging Trends Study, we analyzed responses from non-institutionalized older adults (≥65 years) with diabetes who were homebound (inability to leave home independently or without significant assistance). Subjective well-being was assessed via an 11-item well-being scale. Linear regression identified predisposing, enabling, and need factors associated with well-being. Results: In our weighted population (9.7 million) of community-dwelling older adults with diabetes in 2017, 26% were homebound. Non-Hispanic Black (p = .004) and Hispanic (p = .04) homebound older adults reported significantly higher subjective well-being than non-Hispanic Whites. Greater neighborhood social cohesion was positively associated with well-being (p < .001), while depression (p = .04) and anxiety (p < .001) were negatively associated. Conclusion: Enhancing neighborhood social cohesion, strengthening social support, and expanding access to mental health care may improve the well-being of homebound older adults with diabetes.