EPIDEMIOLOGY OF BEDBOUND STATUS AT THE END OF LIFE IN A NATIONAL SAMPLE OF OLDER ADULTS

Sep 28, 2026

Uploaded by Hazel

Community end-of-life care increasingly includes bedbound individuals, particularly those with dementia and high care needs. Using the National Health and Aging Trends Study (NHATS), the study analyzed bedbound status up to 12 months before death among 3,459 adults aged 65+ who died from 2012–2023. Bedbound status was based on reported frequency, assistance, and difficulty leaving the bed/bedroom. Dementia status used an NHATS algorithm with cognitive testing and diagnosis history, and models estimated predicted probabilities and help hours. Results show nearly 2.5 million decedents bedbound; dementia increased likelihood (23%) and required extensive assistance (3.5 helpers, 123 hours/week).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Abstract

Data source and study population

Definitions and analytical approach

Key findings and implications

Innovation in Aging, 2025, Vol. 9, No. S2 305 Abstract citation ID: igaf122.1029 EPIDEMIOLOGY OF BEDBOUND STATUS AT THE END OF LIFE IN A NATIONAL SAMPLE OF OLDER ADULTS Katherine Ornstein1, Mary Lou Pomeroy1, Hanna Charankevich1, Po-Jen Kung1, Bruce Leff2, and Jennifer Reckrey3, 1. Johns Hopkins University, Baltimore, Maryland, United States, 2. Johns Hopkins University School of Medicine, Baltimore, Maryland, United States, 3. NYU Grossman School of Medicine, New York, New York, United States As the number of individuals living in the community at the end of life grows, many will become bedbound. This may be especially true for individuals with dementia, who have extensive care needs. Using the National Health and Aging Trends Study (NHATS), we examined bedbound status up to 12 months before death among 3,459 community-dwelling individuals ages 65+ who died between 2012–2023. We defined bedbound status using self/proxy reports of frequency, assistance, and difficulty leaving the bed/bedroom. Probable dementia status was defined using an NHATS algorithm that includes cognitive testing and diagnosis history. We estimated the predicted probability of being bedbound by dementia status using survey weights and adjusting for sociodemographic, clinical, and health characteristics. We also examined weekly hours of help received by the bedbound in the 12 months before death. Nearly 2.5 million decedents were bedbound in their last year of life. Individuals with dementia had an increased likelihood of being bedbound (Predicted probability = 23%) and required extensive help (Mean = 3.5 helpers averaging 123 hours/week in the month before death). This is the first national study of bedbound status at the end of life among older adults. A considerable portion of individuals with dementia are confined to bed in the last year of life, requiring extensive help with self-care and other activities. The high number of bedbound 306 Innovation in Aging, 2025, Vol. 9, No. S2 individuals with dementia at the end of life has important implications for the need for paid and unpaid caregiving support, hospice, and other home-based care services.

FAQs

How was bedbound status defined in this study?

Bedbound status was defined using self/proxy reports capturing the frequency, assistance needed, and difficulty leaving the bed or bedroom.

How was probable dementia determined?

Probable dementia status was defined using an NHATS algorithm that incorporates cognitive testing and diagnosis history.

What were the main findings about bedbound individuals in the last year of life?

Nearly 2.5 million decedents were bedbound in their last year of life. Individuals with dementia had a higher predicted likelihood (23%) and required extensive help (about 3.5 helpers averaging 123 hours/week).

Why do the findings matter for care planning?

The high number of bedbound individuals with dementia underscores the need for paid and unpaid caregiving support, hospice services, and other home-based care resources.

Sep 28, 2026

Uploaded by Hazel