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PLOS ONE  2014 

Objectively Assessed Physical Activity and Subsequent Health Service Use of UK Adults Aged 70 and Over: A Four to Five Year Follow Up Study

DOI: 10.1371/journal.pone.0097676

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Abstract:

Objectives To examine the associations between volume and intensity of older peoples' physical activity, with their subsequent health service usage over the following four to five years. Study Design A prospective cohort design using baseline participant characteristics, objectively assessed physical activity and lower limb function provided by Project OPAL (Older People and Active Living). OPAL-PLUS provided data on numbers of primary care consultations, prescriptions, unplanned hospital admissions, and secondary care referrals, extracted from medical records for up to five years following the baseline OPAL data collection. Participants and Data Collection OPAL participants were a diverse sample of 240 older adults with a mean age of 78 years. They were recruited from 12 General Practitioner surgeries from low, middle, and high areas of deprivation in a city in the West of England. Primary care consultations, secondary care referrals, unplanned hospital admissions, number of prescriptions and new disease diagnoses were assessed for 213 (104 females) of the original 240 OPAL participants who had either consented to participate in OPAL-PLUS or already died during the follow-up period. Results In regression modelling, adjusted for socio-economic variables, existing disease, weight status, minutes of moderate-to-vigorous physical activity (MVPA) per day predicted subsequent numbers of prescriptions. Steps taken per day and MVPA also predicted unplanned hospital admissions, although the strength of the effect was reduced when further adjustment was made for lower limb function. Conclusions Community-based programs are needed which are successful in engaging older adults in their late 70s and 80s in more walking, MVPA and activity that helps them avoid loss of physical function. There is a potential for cost savings to health services through reduced reliance on prescriptions and fewer unplanned hospital admissions.

References

[1]  U.S. Department of Health and Human Services (2008) Physical activity guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services.
[2]  Department of Health (2011) Start Active, Stay Active: A report on physical activity for health from the four home countries. London: Chief Medical Officers.
[3]  Wolff JL, Starfield B, Anderson G (2002) Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med 162(20): 2269–76. doi: 10.1001/archinte.162.20.2269
[4]  WHO Global status report on noncommunicable diseases (2010) Available: http://whqlibdoc.who.int/publications/20?11/9789240686458_eng.pdf?ua=1. Accessed: 2 Apr 2014.
[5]  Tooth LR, Hockey R, Treloar S, McClintock C, Dobson A (2012) Does government subsidy for costs of medical and pharmaceutical services result in higher service utilization by older widowed women in Australia? BMC Health Services Research 12: 179. doi: 10.1186/1472-6963-12-179
[6]  Wang F, McDonald T, Reffitt B, Edington DW (2005) BMI, physical activity and health care utilization/costs among Medicare retirees. Obesity Research 13: 1450–1457. doi: 10.1038/oby.2005.175
[7]  Perkins AJ, Clark DO (2001) Assessing the association of walking with health services use and costs among socioeconomically disadvantaged older adults. Prev Med 32(6): 492–501. doi: 10.1006/pmed.2001.0832
[8]  Martin MY, Powell MP, Peel C, Zhu S, Allman R (2006) Leisure-time physical activity and health-care utilization in older adults. J Aging Phys 14(4): 392–410.
[9]  Cabrera MAS, Dellaroza MSG, Trelha CS, Cecilio CH, de Souza SE (2012) One-year follow-up of non-institutionalized dependent older adults: mortality, hospitalization, and mobility. Canadian Journal of Aging 31(3): 357–361. doi: 10.1017/s0714980812000244
[10]  Morina N, Emmelkamp PMG (2012) Health care utilization, somatic and mental health distress, and well-being among widowed and non-widowed female survivors of war. BMC Psychiatry 12: 39. doi: 10.1186/1471-244x-12-39
[11]  Nemet GF, Bailey AJ (2000) Distance and health care utilization among the rural elderly. Social Science and Medicine 50: 1197–1208. doi: 10.1016/s0277-9536(99)00365-2
[12]  Prior MK, Bahret BA, Allen RI, Pasupuleti S (2012) The efficacy of a senior outreach program in the reduction of hospital readmissions and emergency department visits among chronically ill seniors. Social Work in Health Care 51(4): 345–360. doi: 10.1080/00981389.2011.644103
[13]  Roberts RO, Bergstralh EJ, Schmidt L, Jacobsen SJ (1996) Comparison of self-reported and medical record health care utilization measures. Journal of Clinical Epidemiology 49(9): 989–995. doi: 10.1016/0895-4356(96)00143-6
[14]  Sari N (2011) Exercise, physical activity and healthcare utilization: A review of literature for older adults. Maturitas 70: 285–289. doi: 10.1016/j.maturitas.2011.08.004
[15]  Davis MG, Fox KR, Hillsdon M, Coulson JC, Sharp DJ, et al.. (2011) Getting out and about in older adults: the nature of daily trips and their association with objectively assessed physical activity. International Journal of Behavioural Nutrition and Physical Activity doi:10.1186/1479-5868-8-116.
[16]  Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, et al. (2005) The effect of social desirability and social approval on self-reports of physical activity. American Journal of Epidemiology 161(4): 389–398. doi: 10.1093/aje/kwi054
[17]  Bonnefoy M, Normand S, Pachiaudi C, Lacour JR, Laville M, et al. (2001) Simultaneous validation of ten physical activity questionnaires in older men: a doubly labelled water study. J Am Geriatr Soc 49: 28–35. doi: 10.1046/j.1532-5415.2001.49006.x
[18]  Rejeski WJ, Axtell R, Fielding R, Katula J, King AC, et al. (2013) Promoting physical activity for elders with compromised function: the Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity intervention. Clinical Interventions in Aging 8: 1119–1131. doi: 10.2147/cia.s49737
[19]  Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, et al. (1994) A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology 49: M85–M94. doi: 10.1093/geronj/49.2.m85
[20]  Ip EH, Church T, Marshall SA, Zhang Q, Marsh AP, et al. (2013) Physical activity increases gains in and prevents loss of physical function: results from the Lifestyle Interventions and Independence for Elders Pilot study. J Gerontol A Biol Sci Med Sci 68(4): 426–432. doi: 10.1093/gerona/gls186
[21]  Lai JK, Lucas RM, Armstrong M, Banks E (2013) Prospective observational study of physical functioning, physical activity and time outdoors and the risk of hip fracture: a population-based cohort study of 158,057 older adults in the 45 and up study. J Bone Miner Res 10: 2222–31. doi: 10.1002/jbmr.1963
[22]  Craig R, Mindell J, Hirani V (2009) Health survey for England 2008: physical activity and fitness.Leeds: The NHS Information Centre.
[23]  Office of National Statistics (2007) Indices of deprivation 2007 for super output areas Available: http://www.neighbourhood.statistics.gov.?uk/dissemination/instanceSelection.do?JS?Allowed=true&Function=&%24ph=60_61&Curre?ntPageId=61&step=2&datasetFamilyId=1893&?instanceSelection=022838&Next.x=15&Next.?y=16. Accessed: 29 Nov 2012.
[24]  Davis M, Fox KR, Hillsdon M, Sharp D, Coulson J, et al. (2011) Objectively measured physical activity in a diverse sample of older urban-living UK adults. Medicine and Science in Sport and Exercise 43: 647–654. doi: 10.1249/mss.0b013e3181f36196
[25]  Fox KR, Hillsdon M, Sharp D, Cooper AR, Coulson JC, et al. (2011) Neighbourhood deprivation and physical activity in UK older adults. Health and Place 17: 633–640. doi: 10.1016/j.healthplace.2011.01.002
[26]  Sari N (2010) A short walk a day shortens the hospital stay: physical activity and the demand for hospital services for older adults. Can J Public Health 101(5): 385–89.
[27]  Breeze E, Jones D, Wilkinson P, Bulpitt C, Latif A, et al. (2005) Area deprivation, social class and quality of life among people aged 75 years and over in Britain. International Journal of Epidemiology 34: 276–283. doi: 10.1093/ije/dyh328
[28]  Haan M, Kaplan G, Camacho T (1987) Poverty and health: prospective evidence from the Alameda County Study. American Journal of Epidemiology 125: 989–998.
[29]  Macintyre S, Maciver S, Sooman A (1993) Area, class and health: should we be focusing on places or people. Journal of Social Policy 22: 213–234. doi: 10.1017/s0047279400019310
[30]  Petrella RJ, Pedersen L, Cunningham DA, Kovak JJ, Paterson DH (1999) Physician contact with older community patients: is there an association with physical fitness? Preventive Medicine 29(6): 571–6. doi: 10.1006/pmed.1999.0573
[31]  Giné-Garriga M, Martin-Borràs C, Puig-Ribera A, Martín-Cantera C, Solà M, et al.. (2013) The effect of a physical activity program on the total number of primary care visits in inactive patients: A 15-month randomized controlled trial. PLOS ONE 8(6) doi. 10.1371/journal.pone.0066392.
[32]  Smee DJ, Anson JM, Waddington GS, Berry HL (2012) Association between physical functionality and falls risk in community-living older adults. Current Gerontology and Geriatrics Research doi.org/10.1155/2012/864516.
[33]  House of Lords Select Committee on Public Service and Demographic Change (2013) Ready for Ageing Report. London: The Stationery Office.
[34]  Meltzer D, Tavakoly B, Winder R, Richards S, Gericke C, et al.. (2012) Health Care Quality for an Active Later Life: Improving quality of prevention and treatment through information-England 2005 to 2012. Available: http://www.exeter.ac.uk/media/university?ofexeter/medicalschool/pdfs/Health_Care_?Quality_for_an_Active_Later_Life_2012.pd?f. Accessed: 28 Apr 2014.
[35]  Rejeski WJ, Marsh AP, Chmelo E, Prescott AJ, Dobrosielski M, et al. (2009) The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-year follow-up. J Gerontol A BiolSci Med Sci 64(4): 462–7. doi: 10.1093/gerona/gln041
[36]  Marsh AP, Rejeski WJ, Espeland MA, Miller ME, Church TS, et al. (2011) Muscle strength and BMI as predictors of major mobility disability in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P). J Gerontol A BiolSci Med Sci 66A (12): 1376–1383. doi: 10.1093/gerona/glr158
[37]  National Institute for Clinical Excellence (NICE) (2013) Physical activity: brief advice for adults in primary care. Available: http://www.nice.org.uk/nicemedia/live/14?176/63945/63945.pdf. Accessed: 12 Jul 2013.
[38]  Button KS, Ioannidis JPA, Mokrysz C, Nosek BA, Flint J, et al.. (2013) Power failure: why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience 14 (5): : 365–376 doi.10.1038/nrn3475.

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