Document Type


Publication Date

Summer 6-2009

Journal / Book Title

The Gerontologist


Purpose: The purpose of this study is to quantify the effect of residential modification on decreasing the risk of physical function decline in 2 years.

Design: Cohort study using propensity scores method to control for baseline differences between individuals with residential modifications and those without residential modifications.

Participants: Participants (N = 9,447) were from the Second Longitudinal Study on Aging, a nationally representative sample of the civilian noninstitutionalized population, aged 70 years and older in the United States at the time of baseline interview in 1994-1995.

Methods: Participants self-reported residential modifications at baseline (e.g., railings, bathroom modifications). The decline in physical functioning was measured by comparing self-reported activities of daily living at baseline and at 2-year follow-up.

Results: Compared with individuals without baseline modifications, a higher proportion of those with baseline modifications were aged 85 years and older (16% vs. 10%), used special aides (36% vs. 14%), and lived alone (40% vs. 31%). Using a weighted propensity score method, we found a modest decrease in risk of decline at Wave 2 for those with baseline modifications (risk difference = 3.1%). Respondents with a baseline residential modification were less likely to experience a subsequent decline in functional ability (adjusted odds ratio = 0.88, 95% confidence interval = 0.79-0.97) after adjusting for quintile of the propensity score in a survey-weighted regression model.

Implications: Baseline modifications may be associated with reduced risk of decline among a nationally representative sample of older community-dwelling adults. Widespread adoption of residential modifications may reduce the overall population estimates of decline.


Published Citation

Liu, Sze Y., and Kate L. Lapane. "Residential modifications and decline in physical function among community-dwelling older adults." The Gerontologist 49, no. 3 (2009): 344-354. Harvard