Association between weekly amount of home-visit rehabilitation and changes in activities of daily living: A retrospective cohort study using home-visit nursing station records.

Abstract

To examine the association between average weekly minutes of home-visit rehabilitation (HR) and 6-month changes in activities of daily living (ADL) for older adults. Retrospective cohort study using anonymized electronic health record data SETTING: A total of 1,525 home-visit nursing stations across Japan. Adults aged ≥65 years who initiated HR after April 2021 and continued for at least 6 months. HR categorized by average weekly duration: ≤40 min/week, 40 < min/week ≤ 60, 60 < min/week ≤ 80, and 80 < min/week ≤ 120. Change in Barthel index (BI) score from baseline to 6 months. The analysis included 25,409 participants; the mean (SD) age was 82.9 (7.7) years, and 41.5% were males. The mean (SD) baseline BI was 68.7 (27.1). The proportion of HR duration was: ≤40 min/week (40.2%), >40-60 min/week (25.6%), >60-80 min/week (19.0%), and >80-120 min/week (15.1%). Multivariable linear regression showed significant BI improvements in the >40-60 min/week (0.30; 95% confidence interval [CI], 0.05-0.54), >60-80 min/week (1.05; 95% CI, 0.78-1.32), and >80-120 min/week (1.06; 95% CI, 0.77-1.35) groups than that in the ≤40 min/week group. Among participants with care-need level 1, no significant differences were observed across groups. Increased average minutes per week of HR at 6 months is associated with an improvement in BI. This result suggests that an HR of 40 min/week may be insufficient to improve ADL.