The Impact of Psychological Status, Social Well‐Being, and Physical Function on Healthcare Utilization

Boltz, Marie

doi:10.1111/jgs.16331

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…Paired with the observation in this study that higher self-rated health was associated with belonging to the late or early decline group, a few conclusions can be made. Importantly, it is becoming apparent that in some older adults, there may be a trade-off between increased physical activity and exercise and potential harms such as injuries and fall risk [20]. These results support that these risks may correlate with baseline functioning, potentially due to the perception of ability and greater exertion leading to increased risk of injury.…”

Section: Discussionmentioning

confidence: 84%

Trajectories of Short Physical Performance Battery Are Strongly Associated with Future Major Mobility Disability: Results from the LIFE Study

Brown

Lo‐Ciganic

Shao

et al. 2020

JCM

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Short Physical Performance Battery (SPPB) assessment is a widely used measure of lower extremity function, strength, and balance. In the Lifestyles Interventions and Independence for Elders (LIFE) Study, baseline SPPB and changes throughout the trial were strongly associated with major mobility disability (MMD). This study further investigated this association by identifying trajectories of SPPB and evaluating the predictive validity of SPPB trajectories for future MMD. Participants (n = 1635) aged 70–89 years were randomized to a physical activity or health education intervention and assessed every 6 months for MMD. We used group-based trajectory models (GBTMs) to identify trajectories of a binary outcome for a decrease from baseline SPPB of ≥1. Multinomial logistic regression explored baseline factors associated with group membership. Survival analyses evaluated the association between trajectories with MMD. The GBTM identified a 3-group model which included a “No Decline” group (46.0%), “Late Decline” group (27.7%), and an “Early Decline” group (26.3%). Adjusting for all other baseline characteristics, group assignment during the previous follow-up visit was strongly associated with MMD at the subsequent period. Comparisons between groups showed a 2-to-3-fold increase in MMD comparing the “Late” to “No” decline group and a 4-to-5-fold increase in MMD comparing the “Early” to “No” decline group. Group membership and impact on MMD was not different between intervention arms. Group-based trajectories of SPPB scores identified distinct subgroups in LIFE Study participants. Using these group assignments in outcome models were highly associated with MMD. GBTMs have potential to identify and improve prediction of aging-related decline to better design and identify patients for interventions.

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Section: Discussionmentioning

confidence: 84%

Trajectories of Short Physical Performance Battery Are Strongly Associated with Future Major Mobility Disability: Results from the LIFE Study

Brown

Lo‐Ciganic

Shao

et al. 2020

JCM

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Three-Year, Postintervention, Follow-up Comparison of Health Care Resource Utilization and Costs in the Lifestyle Interventions and Independence for Elders (LIFE) Study

Brown

Wang

Groessl

et al. 2020

The Journals of Gerontology: Series A

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Background The Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity (PA) intervention was found to be cost-effective compared to health education (HE). However, long-term effects postintervention are unknown. Method This was a secondary analysis of LIFE Study data linked to Medicare claims data (2014–2016). Participants were linked via Social Security Numbers to Medicare claims data. Utilization and cost variables were analyzed using generalized linear models with negative binomial and Tweedie distributions. Unadjusted means and 95% confidence intervals were compared by year and overall stratified. Each model compared PA versus HE and adjusted for other baseline characteristics and stratified by study site. Additional models were stratified by baseline physical functioning assessment scores. Results Of the 1,635 LIFE Study participants, 804 (53.5%) were linked to Medicare claims with an average of 33 months of follow-up time during the 3-year data linkage period. Mean outpatient (6.6 vs 6.8), inpatient (0.40 vs 0.40), and other utilization metrics were similar between PA and HE groups. Costs were also similar for each group and each type of service, for example, outpatient: $2,070 versus $2,093 and inpatient: $4,704 versus $4,792. Regression results indicated no statistically significant differences between PA and HE groups. Conclusions While the LIFE Study demonstrated that PA reduced mobility disability in older adults and was cost-effective, it did not appear to affect long-term health care utilization costs posttrial. These findings suggest that it remains challenging to affect long-term health care costs using PA interventions effects.

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The Impact of Psychological Status, Social Well‐Being, and Physical Function on Healthcare Utilization

Abstract: This editorial comments on the articles by https://doi.org/10.1111/jgs.16260. and https://doi.org/10.1111/jgs.16313. in this issue.

Cited by 2 publications

References 19 publications

Trajectories of Short Physical Performance Battery Are Strongly Associated with Future Major Mobility Disability: Results from the LIFE Study

Trajectories of Short Physical Performance Battery Are Strongly Associated with Future Major Mobility Disability: Results from the LIFE Study

Three-Year, Postintervention, Follow-up Comparison of Health Care Resource Utilization and Costs in the Lifestyle Interventions and Independence for Elders (LIFE) Study

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