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

Abstract

ObjectivesTo 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 DesignA 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 CollectionOPAL 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.ResultsIn 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.ConclusionsCommunity-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.

Prospective association between late-life physical activity and hospital care utilisation: a 7-year nationwide follow-up study

“…The protective effect of physical activity on subsequent hospital care utilisation in this study, though substantial, is smaller than that described in previous studies [10][11][12]. This may be due to the more comprehensive covariates (such as baseline hospital care utilisation) included in the present study.…”

“…This study demonstrates that late-life physical activity is associated with lower utilisation of subsequent hospital care services, supporting the previous findings of prospective studies based on community-dwelling older adults [11,12]. The protective effect of physical activity on subsequent hospital care utilisation in this study, though substantial, is smaller than that described in previous studies [10][11][12].…”

“…Prospective studies examining the relationship have suffered from methodological limitations such as short follow-up periods [8,9], failure to adjust for health care utilisation at baseline [10][11][12], self-reported health care use [11], and small sample sizes [9,12]. Besides, the previous studies of this topic have been mainly conducted in North America and European countries.…”

An exploration of barriers and facilitators to older adults’ participation in higher impact physical activity and bone health: a qualitative study

“…The evidence for the benefits of physical activity in later life in terms of physical, social and psychological wellbeing, lower incidence of emergency hospital admissions and use of medical prescriptions is growing [7–9]. Furthermore, evidence that physical activity can improve bone strength as assessed by measures such as bone mineral density (BMD) is also increasing (lesser evidence exists for reducing fractures) [10–18].…”

Daily step count and the need for hospital care in subsequent years in a community‐based sample of older Australians

“…The incidence of unplanned hospitalisation was 2.13 times higher in those with low levels than in people with higher daily levels of moderate to vigorous physical activity (mean, 3 v 39 minutes), and 1.81 times higher in those with low daily step counts than in people with high counts (mean, 2100 v 7100 steps). There was also an inverse association with the number of prescriptions written, but not for the number of general practice consultations or referrals to specialist care 8 . The question of reverse causation was not investigated: the possibility that, rather than physical activity improving health, illness causes people to be less active.…”