The Bidirectional Relationship between Depressive Symptoms and Homebound Status among Older Adults

Objectives: This study aimed to examine the bidirectional relationship between depressive symptoms and homebound status among older adults. Method: The study sample included 7,603 community-dwelling older adults from the National Health and Aging Trends Study. A bivariate latent state-trait model of depressive symptoms and homebound status was estimated via structural equation modeling. Results: The model fit the data well (Root Mean Square Error of Approximation =. 02, Comparative Fit Index =. 97, Standardized Root Mean Square Residual =. 06). The relationship between homebound status and depressive symptoms can be decomposed into three parts: a moderate correlation between the stable trait components (r =. 56, p <.001); a contemporary association of the state components (b =. 17, p <.001); and bidirectional lagged effects between the state components. Change in homebound status was as a stronger predictor of depressive symptoms (b =. 19, p <. 001) than change in depressive symptoms was of homebound status (b =. 06, p <. 001; test of difference: Δscaled χ²(1) = 24.2, p <. 001). Discussion: Homebound status and depressive symptoms form a feedback loop to influence each other. Improving the outdoor mobility of older adults may have immediate benefits for reducing depressive symptoms.