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Brar R, Katz A, Ferguson T, Whitlock R, Di Nella M, Bohm C, Rigatto C, Komenda P, Boreskie S, Solmundson C, Kosowan L, Tangri N. Impact of the medical fitness model on long term health outcomes in older adults. BMC Geriatr 2024; 24:695. [PMID: 39164654 PMCID: PMC11337618 DOI: 10.1186/s12877-024-05208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 07/08/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Physical inactivity is common among older adults and is associated with poor health outcomes. Medical fitness facilities provide a medically focused approach to physical fitness and can improve physical activity in their communities. This study aimed to assess the relationship between membership in the medical fitness model and all-cause mortality, health care utilization, and major adverse cardiac events in older adults. METHODS A propensity weighted retrospective cohort study linked individuals that attended medical fitness facilities to provincial health administrative databases. Older adults who had at least 1 year of health coverage from their index date between January 1st, 2005 to December 31st 2015 were included. Controls were assigned a pseudo-index date at random based on the frequency distribution of index dates in members. Members were stratified into low frequency attenders (< 1 Weekly Visits) and regular frequency attenders (> 1 Weekly Visits). Time to event models estimated the hazard ratios (HRs) for risk of all-cause mortality and major adverse cardiac event. Negative binomial models estimated the risk ratios (RRs) for risk of hospitalizations, outpatient primary care visits and emergency department visits. RESULTS Among 3,029 older adult members and 91,734 controls, members had a 45% lower risk of all-cause mortality (HR: 0.55, 95% CI: 0.50 - 0.61), 20% lower risk of hospitalizations (RR: 0.80, 95% CI: 0.75 - 0.84), and a 27% (HR: 0.72, 95% CI: 0.66 - 0.77), lower risk of a major adverse cardiovascular event. A dose-response effect with larger risk reductions was associated with more frequent attendance as regular frequency attenders were 4% more likely to visit a general practitioner for a routine healthcare visit (RR: 1.04, 95% CI: 1.01 - 1.07), but 23% less likely to visit the emergency department (RR: 0.87, 95% CI: 0.82 - 0.92). CONCLUSIONS Membership at a medical fitness facility was associated with a decreased risk of mortality, health care utilization and cardiovascular events. The medical fitness model may be an alternative approach for public health strategies to promote positive health behaviors in older adult populations.
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Affiliation(s)
- Ranveer Brar
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada.
| | - Alan Katz
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Thomas Ferguson
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Reid Whitlock
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
| | - Michelle Di Nella
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
| | - Clara Bohm
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Claudio Rigatto
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Paul Komenda
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Leanne Kosowan
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Navdeep Tangri
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Dinse D, Haak M, Nilsson M, Karlsson S, Olsson Möller U. The influence of the Covid-19 pandemic on municipal meeting places arranging group exercise for older persons. Int J Qual Stud Health Well-being 2023; 18:2235130. [PMID: 37499132 PMCID: PMC10375932 DOI: 10.1080/17482631.2023.2235130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE Many municipalities today, together with other stakeholders, offer group exercises for the older population via municipal meeting places, focusing on promoting good health. During the Covid-19 pandemic, these group exercises either continued in a modified form or ceased. The aim of this study was to explore involved stakeholders' experiences of group exercises for older persons arranged via municipal meeting places during the Covid-19 pandemic. METHODS Six online focus group interviews were conducted with 25 stakeholders, such as decision-makers and representatives from the non-profit sector, from seven municipalities in Sweden. Data were analysed using thematic analysis. FINDINGS The collaboration around the group exercises was challenged due to affected communication and decision-making. The stakeholders described the importance of adapting and finding new ways to offer group exercise. Furthermore, the re-arranging of group exercises created concerns about the well-being of the older persons but also happiness with the older persons ability to act for their own well-being during the pandemic. CONCLUSIONS This study highlights the importance of the municipalities exchanging experiences, making the older persons more involved in the decision-making process, enabling a person-centred encounter with the older persons when exercising in groups, and strengthening supportive environments by sharing the ownership of arranging the group exercises with the older persons.
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Affiliation(s)
- Daniella Dinse
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Maria Haak
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Marie Nilsson
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Staffan Karlsson
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ulrika Olsson Möller
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
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Skałacka K, Błońska K. Physical Leisure Activities and Life Satisfaction in Older Adults. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2148416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Katarzyna Skałacka
- Department of Social Science, Institute of Psychology, Opole University, Opole, Poland
| | - Katarzyna Błońska
- Department of Social Science, Institute of Psychology, Opole University, Opole, Poland
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Jemna DV, David M, Depret MH, Ancelot L. Physical activity and healthcare utilization in France: evidence from the European Health Interview Survey (EHIS) 2014. BMC Public Health 2022; 22:1355. [PMID: 35840906 PMCID: PMC9288017 DOI: 10.1186/s12889-022-13479-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/18/2022] [Indexed: 12/27/2022] Open
Abstract
Background A growing need and focus on preventing and controlling the diseases and promoting a healthier lifestyle is more evident at global, regional, and national levels. In this respect, it is well-known the positive association between physical activity and population’s health, but also its negative association with the demand of healthcare, which could lead to lower spending on healthcare systems. In France, a lack of physical activity, a high prevalence of sedentary behaviours, and a continuous deterioration of these behaviours are observed since 2006. Therefore, promoting and increasing physical activities could contribute to major societal issues. Within this context, the study aims to analyse how the use of different healthcare services are related to physical activity in a nationally representative sample of French population. Methods The data used was retrieved from the second wave of the EHIS-ESPS 2014. The relationship between physical activity and healthcare utilization, controlled by a set of socioeconomic, demographic, and health behaviour factors, was explored both at the level of the entire population and separately for two age groups (less than 65 years, 65 years and older), employing probit and recursive multivariate probit models. Results Our findings underline that the relation between healthcare utilization and physical activity depends on the type of healthcare services and age group. In this respect, only among adult respondents, we observe a significant negative association between physical activity and prescribed medicines consumption and day hospitalization, while preventive services use is positively related to physical activity. Common to both age groups, the positive association of physical activity with general physician services and non-prescribed medicines reveal that moderately and highly active adults and elders may be more health conscious and therefore may seek referrals to generalist and other prevention measures more frequently than their inactive counterparts. This explanation is also sustained by the negative association between physical activity and overnight hospitalization or home healthcare services. Conclusions This study highlights the double role of physical activity on health as preventive measure and treatment and thus support the implementation of public health policies aimed at increasing the level of physical activity in French population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13479-0.
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Affiliation(s)
- Dănuț-Vasile Jemna
- Faculty of Economics and Business Administration, "Alexandru Ioan Cuza" University of Iași, Iași, Romania
| | - Mihaela David
- "Gh. Zane" Institute for Economic and Social Research - Romanian Academy, Iași Branch; "Alexandru Ioan Cuza" University of Iași, Iași, Romania.
| | - Marc-Hubert Depret
- Centre de Recherche sur l'Intégration Economique et Financière, Institut des Risques Industriels, Assurantiels et Financiers, University of Poitiers, Poitiers, France
| | - Lydie Ancelot
- Centre de Recherche sur l'Intégration Economique et Financière, Institut des Risques Industriels, Assurantiels et Financiers, University of Poitiers, Poitiers, France
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The influence of physical activity level on the length of stay in hospital in older men survivors of COVID-19. SPORT SCIENCES FOR HEALTH 2022; 18:1483-1490. [PMID: 35730029 PMCID: PMC9187887 DOI: 10.1007/s11332-022-00948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 04/06/2022] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to verify the influence of physical activity level on the length of hospital stay in older men recovered from COVID-19. In total, 126 older men diagnosed with COVID-19 were admitted to the hospital between September and December 2020. Among them, 70 survived, of which 39 older men were included in the study. Within 30 days after discharge, patients answered the International Physical Activity Questionnaire to measure their physical activity level through phone contact, with questions corresponding to the week before symptom onset. Clinical and laboratorial data from admission, days between onset of symptoms and admission, length of stay, computed tomography abnormalities, and the need for the intensive care unit were collected. The groups (active × sedentary) were compared using the Student t test or Mann-Whitney test for quantitative data and chi-square test was used for categorical data. There is no difference between the groups in characteristics of admission (p > 0.05), except by potassium level. Active older men had a shorter length of stay (6.50 ± 3.46 vs 11.48 ± 7.63 days; p = 0.03), disease duration (15.71 ± 4.84 vs 21.09 ± 7.69 days; p = 0.02), and lower frequency of lung damage when compared to their sedentary counterparts. In conclusion, being physically active prior to infection can attenuate length of hospital stay in older men with COVID-19.
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Pinto AJ, Goessler KF, Fernandes AL, Murai IH, Sales LP, Reis BZ, Santos MD, Roschel H, Pereira RMR, Gualano B. No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:690-696. [PMID: 34391961 PMCID: PMC8358114 DOI: 10.1016/j.jshs.2021.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/22/2021] [Accepted: 07/16/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19. METHODS Hospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement. RESULTS The median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = -0.57 (95% confidence interval (95%CI): -1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: -0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: -0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: -0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050). CONCLUSION Among hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.
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Affiliation(s)
- Ana J Pinto
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Karla F Goessler
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Alan L Fernandes
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Igor H Murai
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Lucas P Sales
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Bruna Z Reis
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Mayara Diniz Santos
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Rosa M R Pereira
- Rheumatology Division, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, Clinical Hospital HCFMUSP, School of Medicine FMUSP, University of Sao Paulo, Sao Paulo, SP 01246903, Brazil; Food Research Center, University of Sao Paulo, Sao Paulo, SP 05508080, Brazil.
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Coughlan D, Saint-Maurice PF, Carlson SA, Fulton J, Matthews CE. Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort. BMJ Open Sport Exerc Med 2021; 7:e001038. [PMID: 33768963 PMCID: PMC7938970 DOI: 10.1136/bmjsem-2021-001038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 01/12/2023] Open
Abstract
Background There is limited information about the association between long-term leisure time physical activity (LTPA) participation and healthcare costs. The purpose of this study was to investigate the association between LTPA over adulthood with later life healthcare costs in the USA. Methods Using Medicare claims data (between 1999 and 2008) linked to the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, we examined associations between nine trajectories of physical activity participation throughout adulthood with Medicare costs. Results Compared with adults who were consistently inactive from adolescence into middle age, average annual healthcare costs were significantly lower for maintainers, adults who maintained moderate (–US$1350 (95% CI: –US$2009 to –US$690) or −15.9% (95% CI: −23.6% to −8.1%)) or high physical activity levels (–US$1200 (95% CI: –US$1777 to –US$622) or −14.1% (95% CI: −20.9% to −7.3%)) and increasers, adults who increased physical activity levels in early adulthood (–US$1874 (95% CI: US$2691 to –US$1057) or −22.0% (95% CI: −31.6% to −12.4%)) or in middle age (–US$824 (95% CI: –US$1580 to –US$69 or −9.7% (95% CI −18.6% to −0.8%)). For the four trajectories where physical activity decreased, the only significant difference was for adults who increased physical activity levels during early adulthood with a decline in middle age (–US$861 (95% CI:–US$1678 to –US$45) or −10.1% (95% CI: −19.7% to −0.5%)). Conclusion Our analyses suggest the healthcare cost burden in later life could be reduced through promotion efforts supporting physical activity participation throughout adulthood.
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Affiliation(s)
- Diarmuid Coughlan
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Surveillance Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Pedro F Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Susan A Carlson
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet Fulton
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Lee BK. Comparison of Prevalence of Hyperlipidemia, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study of 2018 Korea Medical Panel. THE ASIAN JOURNAL OF KINESIOLOGY 2021. [DOI: 10.15758/ajk.2021.23.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is to compare the difference in the prevalence of hyperlipidemia according to the level of physical activity in adults, and to compare the difference between annual personal medical expenses, hospitalization, emergency and outpatient use depending on the level of physical activity for hyperlipidemia patients.METHODS The 2018 Korea medical panel data was used (14,489 adults and 2,559 Hyperlipidemia). Physical activity was measured with short form of IPAQ and converted to MET-minutes per week. The days of hospitalization, and personal medical expenses were compared, and frequency analysis, logistic regression, ANOVA and chi-square were performed.RESULTS The prevalence of hyperlipidemia based on the inactive group were decreased both minimally active group (OR = 0.94) and the active group (OR = 0.74, p<0.01). Annual personal medical expenses I (p<.01) and II (p<.01) with hyperlipidemia were all showed significant differences depending on the level of physical activity. On active group basis, medical expenses showed slight differences of 3.0 to 3.2% with the minimally activity group, but that of the inactive group were 19.3 ~ 21.7% higher. The annual days of hospitalization were 6.8 ± 7.2 days in activity group, minimally activity group 7.1 ± 7.2 days, inactive group 11.7 ± 26.0 days. There was no significant difference in the annual days of hospitalization and emergency between the three groups. In particular, the annual days of outpatient increased sharply at the inactive group. Participation in physical activity has been shown to have a significant effect on hospitalization and decreasing use of emergency rooms.CONCLUSIONS Hyperlipidemia prevalence was similar to inactive groups and minimally activity groups, and that of activity groups was 0.74. On medical expenses of hyperlipidemia, the activity and minimally activity group was similar, the inactivity group was 19.3 to 21.7% higher. Physical activity was found to have a positive effect on hospitalization and emergency use reduction.
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Auerswald T, Meyer J, von Holdt K, Voelcker-Rehage C. Application of Activity Trackers among Nursing Home Residents-A Pilot and Feasibility Study on Physical Activity Behavior, Usage Behavior, Acceptance, Usability and Motivational Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6683. [PMID: 32937840 PMCID: PMC7559724 DOI: 10.3390/ijerph17186683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/27/2020] [Accepted: 09/05/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess physical activity and sedentary behavior, as well as the usage behavior, usability, acceptance, and motivational impact of an applied activity tracker among nursing home residents. Physical activity and usage behavior were measured among 22 residents (68 to 102 years) by use of a commercial activity tracker worn during waking hours for 77 days on average. Usability, acceptance, and motivational impact of the tracker were examined using an adapted questionnaire. Participants walked, on average, 1007 ± 806 steps per day and spent, on average, more than 9 h (77.2% of their waking time) sedentary. The average steps/day increased significantly within the first five weeks of wearing the activity tracker. The acceptance rate was high (94.4%). The tracker was used for 65.4% of the individual study period, and usage behavior did not significantly change during the first five wearing weeks. Participants with a usage time of ≥50% walked significantly more steps per day than those with a lower usage. Overall, we were able to reveal that the residents were highly inactive and sedentary. The results support the feasibility of a long-term application of activity trackers to assess or even increase physical activity behavior.
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Affiliation(s)
- Tina Auerswald
- Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126 Chemnitz, Germany;
| | - Jochen Meyer
- OFFIS—Institute for Information Technology Oldenburg, Escherweg 2, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Kai von Holdt
- OFFIS—Institute for Information Technology Oldenburg, Escherweg 2, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126 Chemnitz, Germany;
- Department of Neuromotor Behavior and Exercise, University of Münster, Horstmarer Landweg 62 b, 48149 Münster, Germany
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Gomes GAO, Brown WJ, Codogno JS, Mielke GI. Twelve year trajectories of physical activity and health costs in mid-age Australian women. Int J Behav Nutr Phys Act 2020; 17:101. [PMID: 32778110 PMCID: PMC7418418 DOI: 10.1186/s12966-020-01006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
Background Few studies have examined relationships between physical activity (PA) during mid-age and health costs in women. The aim of this study was to investigate associations between PA levels and trajectories over 12 years with medical and pharmaceutical costs in mid-age Australian women. Methods Data from 6953 participants in the Australian Longitudinal Study on Women’s Health (born in 1946–1951) were analysed in 2019. PA was self-reported in 2001 (50-55y), 2007 (56-61y) and 2013 (62-67y). PA data were linked with 2013–2015 data from the Medicare (MBS) and Pharmaceutical (PBS) Benefits Schemes. Quantile regression was used to examine associations between PA patterns [always active, increasers, decreasers, fluctuaters or always inactive (reference)] with these medical and pharmaceutical costs. Results Among women who were consistently inactive (< 500 MET.minutes/week) in 2001, 2007 and 2013, median MBS and PBS costs (2013 to 2015) were AUD4261 and AUD1850, respectively. Those costs were AUD1728 (95%CI: 443–3013) and AUD578 (95%CI: 426–729) lower among women who were consistently active in 2001, 2007 and 2013 than among those who were always inactive. PBS costs were also lower in women who were active at only one survey (AUD205; 95%CI: 49–360), and in those whose PA increased between 2001 and 2013 (AUD388; 95%CI: 232–545). Conclusion Maintaining ‘active’ PA status was associated with 40% lower MBS and 30% lower PBS costs over three years in Australian women. Helping women to remain active in mid-life could result in considerable savings for both women and the Australian government.
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Affiliation(s)
- Grace A O Gomes
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luiz, s/n, São Carlos, SP, 13565-905, Brazil. .,School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia.
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia
| | - Jamile S Codogno
- Department of Physical Education, Presidente Prudente, São Paulo State University, R. Roberto Símonsen, 305 - Centro Educacional, Pres. Prudente, SP, 19060-900, Brazil
| | - Gregore I Mielke
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia QLD, Brisbane, Queensland, 4072, Australia
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Ek A, Kallings LV, Ekström M, Börjesson M, Ekblom Ö. Subjective reports of physical activity levels and sedentary time prior to hospital admission can predict utilization of hospital care and all-cause mortality among patients with cardiovascular disease. Eur J Cardiovasc Nurs 2020; 19:691-701. [PMID: 32370681 PMCID: PMC7817990 DOI: 10.1177/1474515120921986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background In prevention, sedentary behaviour and physical activity have been associated
with risk of cardiovascular disease and mortality. Less is known about
associations with utilization of hospital care. Aim To investigate whether physical activity level and sedentary behaviour prior
to cardiac ward admission can predict utilization of hospital care and
mortality among patients with cardiovascular disease. Methods Longitudinal observational study including 1148 patients admitted and treated
in cardiac wards in two hospitals. Subjective reports of physical activity
levels and sedentary time prior to admission were collected during inpatient
care and categorized as low, medium or high. The associations between
physical activity level and sedentary time with hospital stay, readmission
and mortality were analysed using linear, logistic and Cox regressions. Results Median hospital stay was 2.1 days. One higher step in the physical activity
level, or lower sedentary time, was related to an approximately 0.9 days
shorter hospital stay. Sixty per cent of patients were readmitted to
hospital. The risk of being readmitted was lower for individuals reporting
high physical activity and low sedentary time (odds ratios ranging between
0.44 and 0.91). A total of 200 deaths occurred during the study. Mortality
was lower among those with high and medium physical activity levels and low
sedentary time (hazard ratios ranging between 0.36 and 0.90). Conclusion Both physical activity level and sedentary time during the period preceding
hospitalization for cardiac events were predictors of hospital utilization
and mortality. This highlights the prognostic value of assessing patients’
physical activity and sedentary behaviour.
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Affiliation(s)
- Amanda Ek
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden.,Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Sweden
| | - Lena V Kallings
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden.,Unit of General Practice, Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Mattias Ekström
- Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Sweden.,Department of Medicine, Solna, Karolinska Institutet, Sweden
| | - Mats Börjesson
- Department of Neuroscience and Physiology, Sahlgrenska Academy & Sahlgrenska University Hospital/Ostra, Sweden.,Centre for Health and Performance, Department of Food, Nutrition and Sport Science, University of Gothenburg, Sweden
| | - Örjan Ekblom
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden
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12
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Lee BK. Comparison of Prevalence of Diabetes Mellitus, Medical Expenses, Inpatient, Emergency and Outpatient According to the Level of Physical Activity of Korean Adults: A Cross-Sectional Study. THE ASIAN JOURNAL OF KINESIOLOGY 2019. [DOI: 10.15758/ajk.2019.21.3.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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13
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Wang F, Zhang LY, Zhang P, Cheng Y, Ye BZ, He MA, Guo H, Zhang XM, Yuan J, Chen WH, Wang YJ, Yao P, Wei S, Zhu YM, Liang Y. Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China. Curr Med Sci 2019; 39:483-492. [PMID: 31209822 DOI: 10.1007/s11596-019-2063-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 11/30/2018] [Indexed: 01/09/2023]
Abstract
The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.
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Affiliation(s)
- Fang Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Liu-Yi Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yao Cheng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bei-Zhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei-An He
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Guo
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Min Zhang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Yuan
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Hong Chen
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - You-Jie Wang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Yao
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi-Mei Zhu
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7JA, UK
| | - Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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14
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Lee BK. Comparison of Prevalence of Hypertension and Medical Expenses According to the Level of Physical Activity of Korean Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2018. [DOI: 10.15758/ajk.2018.20.4.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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15
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Associations between physical activity, medical costs and hospitalisations in older Australian women: Results from the Australian Longitudinal Study on Women’s Health. J Sci Med Sport 2018; 21:604-608. [DOI: 10.1016/j.jsams.2017.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/26/2017] [Accepted: 10/14/2017] [Indexed: 11/20/2022]
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16
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Peralta M, Martins J, Guedes DP, Sarmento H, Marques A. Socio-demographic correlates of physical activity among European older people. Eur J Ageing 2018. [PMID: 29531510 DOI: 10.1007/s10433-017-0430-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
From a public health perspective, identifying factors related to attaining the physical activity (PA) recommendations is important in order to identify subgroups for intervention programs. The aim of this study is to identify the socio-demographic correlates of attaining the recommended levels of PA in the older European population. Using data from the European Social Survey round 6, PA and socio-demographic characteristics were collected from 10,148 participants (4556 men, 5592 women), aged 65 years and over, from 28 countries in 2012. PA was accessed using the question "On how many of the last seven days did you walk quickly, do sports, or other PA for 30 min or longer?" and meeting PA guidelines was assessed using World Health Organization criteria. Overall, 59.7% of the participants attained the PA-recommended levels. The likelihood of attaining PA recommendations was higher among older people with higher education levels (p < 0.05; p < 0.01; p < 0.001). Men who lived in a town or small city (p < 0.05) and lived in a rural area (p < 0.001) were more likely to attain the PA recommendations. Women who lived with a partner were more likely to attain the PA recommendations (p < 0.001). Promotion of PA is critical to health among older people; therefore, intervention programs must consider these socio-demographic factors when planning an increase in PA.
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Affiliation(s)
- Miguel Peralta
- 1Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, Dafundo, 1499-002 Lisbon, Portugal
| | - João Martins
- 2Laboratório de Pedagogia, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, Lisbon, Portugal.,3Faculdade de Educação Física e Desporto, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | | | - Hugo Sarmento
- 5Sport and Physical Activity Research Centre (CIDAF), Faculty of Sport Sciences and Physhical Education, University of Coimbra, Coimbra, Portugal
| | - Adilson Marques
- 6Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.,7Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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17
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Johansson T, Keller S, Sönnichsen AC, Weitgasser R. Cost analysis of a peer support programme for patients with type 2 diabetes: a secondary analysis of a controlled trial. Eur J Public Health 2017; 27:256-261. [PMID: 27694160 DOI: 10.1093/eurpub/ckw158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background This study aimed to explore if group-based peer support as an additional component to a disease management programme (DMP) in type 2 diabetes can reduce the number of prescribed drugs; hospital admissions; and length of hospital stay and therefore be a cost-effective model. Methods Controlled study based on a secondary data analysis of a cluster randomized trial. Our study population was general practitioners and patients in the province of Salzburg. The 24-months intervention consisted of regular group meetings facilitated by trained peer supporters. The groups exercised together, discussed diabetes related topics, and received support by professionals. Data was anonymously collected on clusters through the statutory health insurance. Results Data were available of 118 (82.5%,17 clusters of the patients in the original randomized trial) participants in the intervention and 143 (77.3%,19 clusters) in the control groups. The length of hospital stay was shorter in the intervention groups compared with controls. The mean difference during the 24-month study period was -40.13 days (95% CI - 78.54 to - 1.71, P = 0.041) in favour of the intervention groups. No differences were seen in the number of prescribed drugs and hospital admission. Estimated yearly savings by reducing the length of hospital stay was €1660.60 per patient. Conclusion A group-based peer support programme as an additional component of a DMP in type 2 diabetes is a promising approach to optimize diabetes care and to enhance lifestyle interventions in primary care. Peer support seems to reduce length of hospital stay and could therefore be a cost-effective model.
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Affiliation(s)
- Tim Johansson
- Institute of General Practice, Family Medicine, and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Sophie Keller
- Institute of General Practice, Family Medicine, and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Andreas C Sönnichsen
- Institute of General Practice and Family Medicine, University of Witten/Herdecke, Witten, Germany
| | - Raimund Weitgasser
- Department of Internal Medicine, Privatklinik Wehrle-Diakonissen, Salzburg, Austria.,Paracelsus Medical University, Salzburg, Austria
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18
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Marsh AP, Applegate WB, Guralnik JM, Jack Rejeski W, Church TS, Fielding RA, Gill TM, King AC, Kritchevsky SB, Manini TM, McDermott MM, Newman AB, Stowe CL, Walkup MP, Pahor M, Miller ME. Hospitalizations During a Physical Activity Intervention in Older Adults at Risk of Mobility Disability: Analyses from the Lifestyle Interventions and Independence for Elders Randomized Clinical Trial. J Am Geriatr Soc 2017; 64:933-43. [PMID: 27225353 DOI: 10.1111/jgs.14114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To determine whether moderate-intensity physical activity (PA) and health education (HE) are differentially associated with categories of hospitalizations or subgroups of participants. DESIGN Multicenter randomized controlled trial in which participants were randomized to a PA or HE program for an average of 2.6 years. SETTING Eight field centers. PARTICIPANTS Sedentary men and women aged 70-89 with lower extremity physical limitations but able to walk 400-m in 15 minutes or less (N = 1,635). INTERVENTIONS Structured, moderate-intensity PA (n = 818) at a center (2×/wk) and at home (3-4×/wk) that included aerobic, strength, balance, and flexibility training or HE (n = 817) of educational workshops and upper extremity stretching exercises. MEASUREMENTS All-cause inpatient hospitalizations ascertained at 6-month intervals. RESULTS There were 1,458 hospitalizations (49.1% of PA, 44.4% of HE; risk difference = 4.68%, 95% confidence interval (CI) = -0.18-9.54; hazard ratio (HR) = 1.16, 95% CI = 1.00-1.34). The intervention effect on incident hospitalization did not differ according to race, sex, Short Physical Performance Battery score, age, or history of cardiovascular disease or diabetes mellitus. PA was associated with higher rates of hospitalization in the middle baseline gait speed category, than HE (<0.8 m/s: HR = 0.93, 95% CI = 0.76-1.14; 0.8-1.0 m/s: HR = 1.54, 95% CI = 1.23-1.94; >1.0 m/s: HR = 1.05, 95% CI = 0.67-1.65; interaction P = .005). CONCLUSION A PA program in older adults at risk for mobility disability did not lead to a different risk of specific types of hospitalizations than a HE program overall. Baseline gait speed may be a marker for risk of hospitalization during a PA intervention, because individuals with moderate baseline gait speed in the PA group had slightly higher rates of hospitalization than those in the HE group. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01072500.
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Affiliation(s)
- Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - William B Applegate
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina
| | - Jack M Guralnik
- Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Timothy S Church
- Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Thomas M Gill
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Abby C King
- Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, California.,Department of Medicine, School of Medicine, Stanford University, Stanford, California
| | - Stephen B Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Sticht Center on Aging, Wake Forest University, Winston-Salem, North Carolina
| | - Todd M Manini
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mary M McDermott
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Anne B Newman
- Department of Epidemiology and Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia L Stowe
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Michael P Walkup
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, College of Medicine, University of Florida, Gainesville, Florida.,Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael E Miller
- Division of Public Health Sciences, Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
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19
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Prescripción de actividad física en la enfermedad pulmonar obstructiva crónica… y más allá. Med Clin (Barc) 2017; 149:24-25. [DOI: 10.1016/j.medcli.2016.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 11/23/2022]
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20
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Kang SW, Xiang X. Physical activity and health services utilization and costs among U.S. adults. Prev Med 2017; 96:101-105. [PMID: 28040516 DOI: 10.1016/j.ypmed.2016.12.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/20/2016] [Accepted: 12/23/2016] [Indexed: 11/28/2022]
Abstract
The objective of this study was to examine the relationship between physical activity and health services utilization and costs among adults aged 18 or older in the U.S. Data came from the Medical Expenditure Panel Survey-Household component from 2007 through 2011 (n=117,361). Regular physical activity was defined as spending half an hour or more in moderate or vigorous physical activity at least three times a week. The following categories of self-reported health services utilization and costs were examined: preventive, office-based, outpatient, inpatient, emergency department, home health, and prescription medicines. The association of physical activity and health services utilization and costs was estimated using two-part models. Adults who engaged in regular physical activity were more likely to use preventive (ORs ranged from 1.06 to 1.34, p<0.05) and office-based services (OR=1.05, 95% CI=1.01-1.10, p<0.05). Combining results from both parts of the two-part models, physically active adults incurred significantly lower utilization of inpatient (0.09 vs 0.12 visit per person), emergency room (0.18 vs 0.19 visit per person), home health care (1.21 vs 1.92 visit per person), and prescription medicines (12.66 vs 13.75 number of prescriptions per person) and spent $27 less per capita expenditures for office-based visits, $351 less for inpatient visits, and $52 less for home health care visits. Promoting regular physical activity may reduce health care costs through decreasing demand for secondary and tertiary care services.
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Affiliation(s)
- Sung-Wan Kang
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W. Nevada, Urbana, IL 61801, USA.
| | - Xiaoling Xiang
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair Street, Chicago, IL 60611, USA.
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21
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Ewald BD, Oldmeadow C, Attia JR. Daily step count and the need for hospital care in subsequent years in a community‐based sample of older Australians. Med J Aust 2017; 206:126-130. [DOI: 10.5694/mja16.00640] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Ben D Ewald
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW
| | - Christopher Oldmeadow
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW
| | - John R Attia
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW
- John Hunter Hospital, Newcastle, NSW
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22
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Musich S, Wang SS, Hawkins K, Greame C. The Frequency and Health Benefits of Physical Activity for Older Adults. Popul Health Manag 2016; 20:199-207. [PMID: 27623484 PMCID: PMC5488312 DOI: 10.1089/pop.2016.0071] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The benefits of physical activity (PA) for older adults have been demonstrated in reduced prevalence of common chronic conditions, improved mental health, decreased cognitive decline, and reduced mortality rates. Less is understood concerning the health impacts of light-to-moderate intensity PA. The purpose of this study was to estimate light-to-moderate PA frequency levels-low (0-2 days/week), intermediate (3-4 days/week) and high (≥5 days/week)-among AARP Medicare Supplement insureds, identify characteristics, and estimate the association of PA levels with the prevalence of selected chronic conditions, health care utilization, and expenditures. In 2015, surveys were sent to a random sample of insureds. PA was determined from survey responses querying self-reported days per week of at least 30 minutes of light-to-moderate PA. Multivariate regression models, adjusting for confounding covariates and survey nonresponse bias, were utilized to determine the characteristics and association of intermediate and high PA levels with health outcomes. In a second analysis, results were stratified by age groups: 65-69, 70-79, and ≥80 years. Among survey respondents (n = 17,676), 23.3%, 33.9%, and 42.9% engaged in low, intermediate, and high PA, respectively. The strongest predictors of intermediate and high PA included being male, younger, self-reporting better health, using fewer prescription drugs, and being less likely to be diagnosed with common chronic conditions or depression. Those engaged in intermediate and high PA, overall and across age groups, had significantly lower health care utilization and expenditures and lower prevalence of most chronic conditions. Efforts to increase intermediate and high levels of PA among older adults should be encouraged.
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Affiliation(s)
| | | | | | - Chris Greame
- 2 AARP Services, Inc., Washington, District of Columbia
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23
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Bueno DR, Marucci MDFN, Codogno JS, Roediger MDA. [The costs of physical inactivity in the world: a general review]. CIENCIA & SAUDE COLETIVA 2016; 21:1001-10. [PMID: 27075999 DOI: 10.1590/1413-81232015214.09082015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
There is convincing evidence in the scientific literature of the effectiveness of regular physical activity and physical exercise in the conservation of health and the prevention of various ailments. However, studies into the association between costs of medical services and physical inactivity have not been duly addressed. International studies have quantified these costs and revealed the association between physical activity and/or sedentary behavior. Therefore, this review sought to gather information available from several countries and analyze the global costs associated with physical inactivity over the past few decades. The results of twenty-four original and well-researched articles in nine countries, including Brazil, were analyzed. The results showed that physical inactivity, irrespective of the method of classification, is burdensome to the economy of health worldwide, and directly responsible for the high cost of medication, the incidence of hospitalization and the frequency of medical appointments. The costs of the group of the physically inactive population affected by chronic diseases feature among the major components of the total costs involved in public health.
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Affiliation(s)
| | | | - Jamile Sanches Codogno
- Faculdade de Ciências e Tecnologia de Presidente Prudente, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo, SP, Brasil
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24
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Bocksnick J, Sharp-Chrunik B, Bjerkseth A. Changes in Range of Motion in Response to Acute Exercise in Older and Younger Adults: Implications for Activities of Daily Living. ACTIVITIES ADAPTATION & AGING 2016. [DOI: 10.1080/01924788.2016.1127045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Fisher KL, Harrison EL, Reeder BA, Sari N, Chad KE. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey. J Aging Res 2015; 2015:425354. [PMID: 26347491 PMCID: PMC4541001 DOI: 10.1155/2015/425354] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/17/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. To examine relationships between leisure time physical activity (LTPA) and health services utilization (H) in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years) were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA) was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50-65-year-old individuals were 27% less likely to report any GP consultations (ORadj = 0.73; P < 0.001) and had 8% fewer GP consultations annually (IRRadj = 0.92; P < 0.01) than their inactive peers. Active persons aged 65-79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj = 0.82, P < 0.05). Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.
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Affiliation(s)
- Koren L. Fisher
- Department of Kinesiology, California State University, Fullerton 800 N. State College Boulevard, Fullerton, CA 92831, USA
- Department of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada S7N 5B2
| | - Elizabeth L. Harrison
- School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, SK, Canada S7N 0W3
| | - Bruce A. Reeder
- Department of Community Health and Epidemiology, University of Saskatchewan, Box 7, Health Science Building, 107 Wiggins Road, Saskatoon, SK, Canada S7N 5E5
| | - Nazmi Sari
- Department of Economics, University of Saskatchewan, Arts 815, 9 Campus Drive, Saskatoon, SK, Canada S7N 5A5
| | - Karen E. Chad
- Department of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada S7N 5B2
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26
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Gibbs JC, McArthur C, Milligan J, Clemson L, Lee L, Boscart VM, Heckman G, Rojas-Fernandez C, Stolee P, Giangregorio LM. Measuring the implementation of a group-based Lifestyle-integrated Functional Exercise (Mi-LiFE) intervention delivered in primary care for older adults aged 75 years or older: a pilot feasibility study protocol. Pilot Feasibility Stud 2015; 1:20. [PMID: 27965799 PMCID: PMC5154042 DOI: 10.1186/s40814-015-0016-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/19/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Declines in function and quality of life, and an increased risk of cardiovascular events, falls, and fractures occur with aging and may be amenable to exercise intervention. Primary care is an ideal setting for identifying older adults in need of exercise intervention. However, a cost-effective, generalizable model of chronic disease management using exercise in a real-world setting remains elusive. Our objective is to measure the feasibility, potential effectiveness, and implementation of an evidence-based Lifestyle-integrated Functional strength and balance Exercise (LiFE) intervention adapted as a group-based format (Mi-LiFE) for primary care to promote increased physical activity levels in older adults aged 75 years or older. We hypothesize that the intervention will be feasible without modification if ≥30 individuals are recruited over 6 months, ≥75 % of our sample is retained, and ≥50 % of our sample complete exercises ≥3 days per week. METHODS/DESIGN A pre-post pilot study design will be used to evaluate feasibility, potential effectiveness, and implementation outcomes over a 6-month period in physically inactive older adults ≥75 years recruited from a local family health team practice. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework will be applied to evaluate the public health effects of the intervention including outcomes both at the individual and organizational levels. A physical therapist will teach participants how to integrate strength and balance activities into their daily lives over one individual and four group-based sessions, and two phone calls. Assessments will be completed at baseline and 6 months. Feasibility outcomes include recruitment over 6 months, retention at follow-up, and adherence measured by activity diaries. Change in patient-centered and implementation outcomes that will be evaluated include physical activity levels using accelerometers and International Physical Activity Questionnaire, physical performance using short physical performance battery, quality of life using EQ5D questionnaire, falls and harms using daily calendar diaries and self-report, fidelity using descriptive feedback, barriers and facilitators to implementation using thematic content analysis, and process outcomes. DISCUSSION The feasibility and implementation of the Mi-LiFE intervention in primary care for older adults will be evaluated, as well as the effects of the intervention on secondary outcomes. If the intervention appears feasible, we will use the resultant information to design a larger trial. TRIAL REGISTRATION ClinicalTrials.gov: NCTO2266225.
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Affiliation(s)
- Jenna C. Gibbs
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Caitlin McArthur
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - James Milligan
- Centre for Family Medicine-Family Health Team, Department of Family Medicine, McMaster University, 10B Victoria Street South, Kitchener, ON N2G 1C5 Canada
| | - Lindy Clemson
- Faculty of Health Sciences, University of Sydney, 75 East Street Lidcombe, Sydney, NSW 2006 Australia
| | - Linda Lee
- Centre for Family Medicine-Family Health Team, Department of Family Medicine, McMaster University, 10B Victoria Street South, Kitchener, ON N2G 1C5 Canada
| | - Veronique M. Boscart
- School of Health & Life Sciences and Community Services, Conestoga College, 299 Doon Valley Drive, Kitchener, ON N2G 4M4 Canada
| | - George Heckman
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Carlos Rojas-Fernandez
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Paul Stolee
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
| | - Lora M. Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1 Canada
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Souza AMR, Fillenbaum GG, Blay SL. Prevalence and correlates of physical inactivity among older adults in Rio Grande do Sul, Brazil. PLoS One 2015; 10:e0117060. [PMID: 25700161 PMCID: PMC4336142 DOI: 10.1371/journal.pone.0117060] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 12/18/2014] [Indexed: 12/24/2022] Open
Abstract
Background Current information on the epidemiology of physical inactivity among older adults is lacking, making it difficult to target the inactive and to plan for interventions to ameliorate adverse effects. Objectives To present statewide representative findings on the prevalence of physical inactivity among older community residents, its correlates and associated health service use. Methods A representative non-institutionalized random sample of 6963 individuals in Rio Grande do Sul, Brazil, aged ≥60 years, was interviewed face-to-face. Information was obtained on demographic characteristics, social resources, health conditions and behaviors, health service use, and physical inactivity. Controlled logistic regression was used to determine the association of physical inactivity with these characteristics. Results Overall, 62% reported no regular physical activity. Physical inactivity was significantly more prevalent among women, older persons, those with lower education and income, Afro-Brazilians (73%; White: 61%; “other”: 64%), those no longer married, and was associated with multiple individual health conditions and impaired activities of daily living (ADL). In adjusted analyses, associations remained for sociodemographic characteristics, social participation, impaired self-rated health, ADL, vision, and depression (odds ratios (OR) 1.2–1.7). Physically inactive respondents were less likely to report outpatient visits (OR 0.81), but more likely to be hospitalized (OR 1.41). Conclusions Physical inactivity is highly prevalent, particularly among Afro -Brazilians. It is associated with adverse sociodemographic characteristics; lack of social interaction; and poor self-rated health, ADL, vision, and depression; although not with other health conditions. Self-care may be neglected, resulting in hospitalization.
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Affiliation(s)
- Adelle M. R. Souza
- Department of Psychiatry, Federal University of São Paulo, (Escola Paulista de Medicina—UNIFESP), São Paulo, São Paulo, Brazil
| | - Gerda G. Fillenbaum
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, United States of America
| | - Sergio L. Blay
- Department of Psychiatry, Federal University of São Paulo, (Escola Paulista de Medicina—UNIFESP), São Paulo, São Paulo, Brazil
- * E-mail:
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Peeters GMEEG, Mishra GD, Dobson AJ, Brown WJ. Health care costs associated with prolonged sitting and inactivity. Am J Prev Med 2014; 46:265-72. [PMID: 24512865 DOI: 10.1016/j.amepre.2013.11.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 11/13/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Physical inactivity and prolonged sitting are associated with negative health outcomes. PURPOSE To examine the health-related costs of prolonged sitting and inactivity in middle-aged women. METHODS Australian Longitudinal Study on Women's Health participants (born 1946-1951) answered questions about time spent sitting, walking, and in moderate and vigorous leisure activities in 2001 (n=6108); 2004 (n=5902); 2007 (n=5754); and 2010 (n=5535) surveys. Sitting time was categorized as low (0-4); moderate (5-7); and high (≥8 hours/day). Physical activity was categorized as inactive (<40); low (40-600); moderate (600-1200); and high (≥1200 MET-minutes/week). National health insurance claims data averaged over the survey year ±1 year were used to calculate annual costs (Australian dollars [AU$]). Differences between categories in median costs were estimated using quantile regression over four surveys with bootstrapped 95% CIs. Analyses were performed in 2013. RESULTS In 2010, annual median costs were AU$689 (interquartile range [IQR]=274, 1541) in highly active participants; AU$741 (IQR=279, 1690) in inactive participants; AU$671 (IQR=273, 1551) in participants with low sitting time; and AU$709 (IQR=283, 1575) in participants with high sitting time. The difference in median costs for inactive and highly active participants was AU$94 (CI=57, 131) after adjustment for confounders. No statistically significant associations were found between sitting time and costs. When sitting and physical activity were combined, high sitting time did not add to the inactivity-associated increased costs. Associations were consistent across normal-weight, overweight, and obese subgroups. CONCLUSIONS Physical inactivity, but not prolonged sitting, was associated with higher health-related costs in middle-aged women.
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Affiliation(s)
- G M E E Geeske Peeters
- University of Queensland, School of Human Movement Studies, Brisbane, Australia; School of Population Health, Brisbane, Australia.
| | | | | | - Wendy J Brown
- University of Queensland, School of Human Movement Studies, Brisbane, Australia
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Almeida OP, Khan KM, Hankey GJ, Yeap BB, Golledge J, Flicker L. 150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12 201 older Australian men. Br J Sports Med 2013; 48:220-5. [DOI: 10.1136/bjsports-2013-092814] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rydwik E, Welmer AK, Kåreholt I, Angleman S, Fratiglioni L, Wang HX. Adherence to physical exercise recommendations in people over 65--the SNAC-Kungsholmen study. Eur J Public Health 2012; 23:799-804. [PMID: 23115329 DOI: 10.1093/eurpub/cks150] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is limited knowledge regarding to what extent the older population meet the recommendations of physical exercise, especially fitness-enhancing exercise. This study assessed participation in health- and fitness-enhancing exercises in people aged >65, and explored to what extent the possible differences in meeting current recommendations differs by age, gender and education. METHODS The study population was derived from the Swedish National study on Aging and Care, and consisted of a random sample of 2593 subjects, aged 65+ years. Participation in health- and fitness-enhancing exercise according to the WHO and the American College of Sports Medicine's recommendations in relation to age, gender and education was evaluated using multinomial logistic regression adjusted for health indicators and physical performance. RESULTS According to the recommendations, 46% of the participants fulfilled the criteria for health-enhancing and 16% for fitness-enhancing exercises. Independent of health indicators and physical performance, women <80 years of age were less likely than men to participate in fitness-enhancing exercise, but they participated more in health-enhancing exercise. In the advanced age group (80+ years), women were less likely to participate both in fitness- and health-enhancing exercise. Advanced age and low education were negatively related to participation in both health- and fitness-enhancing exercise independent of health indicators, but the association was not observed among people with fast walking speed. CONCLUSION Promoting physical exercise and encouraging participation among older adults with lower education, especially among those with initial functional decline, may help to reduce adverse health outcomes.
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Affiliation(s)
- Elisabeth Rydwik
- 1 Departement of Neurobiology, Caring Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Kim J, Park S. [Impact of level of physical activity on healthcare utilization among Korean adults]. J Korean Acad Nurs 2012; 42:199-206. [PMID: 22699169 DOI: 10.4040/jkan.2012.42.2.199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was done to identify the impact of physical activity on healthcare utilization among Korean adults. METHODS Drawing from the 2008 Korean National Health and Nutrition Examination Survey (NHANES IV-2), data from 6,521 adults who completed the Health Interview and Health Behavior Surveys were analyzed. Association between physical activity and healthcare utilization was tested using the χ²-test. Multiple logistic regression analysis was used to calculate the odds ratios of using outpatient and inpatient healthcare for different levels of physical activity after adjusting for predisposing, enabling, and need factors. A generalized linear model applying a negative binomial distribution was used to determine how the level of physical activity was related to use of outpatient and inpatient healthcare. RESULTS Physically active participants were 16% less likely to use outpatient healthcare (OR, 0.84; 95% CI, 0.74-0.97) and 23% less likely to use inpatient healthcare (OR, 0.77; 95% CI, 0.63-0.93) than physically inactive participants. Levels of outpatient and inpatient healthcare use decreased as levels of physical activity increased, after adjusting for relevant factors. CONCLUSION An independent association between being physically active and lower healthcare utilization was ascertained among Korean adults indicating a need to develop nursing intervention programs that encourage regular physical activity.
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Affiliation(s)
- Jiyun Kim
- Department of Nursing, Gachon University, Seongnam, Korea
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Aoyagi Y, Shephard RJ. A model to estimate the potential for a physical activity-induced reduction in healthcare costs for the elderly, based on pedometer/accelerometer data from the Nakanojo Study. Sports Med 2011; 41:695-708. [PMID: 21846160 DOI: 10.2165/11590530-000000000-00000] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The rising healthcare costs associated with an aging population have become an urgent fiscal problem. However, evidence of the efficacy of preventive programmes is limited, since almost all studies have involved only small numbers of highly selected participants. This article examines potential physical activity-induced decreases in healthcare expenses, applying a theoretical model to the Nakanojo Study of habitual physical activity and health in an entire elderly community. The Nakanojo Study has shown substantial associations of health with both step count and the duration of moderate effort (intensity >3 metabolic equivalents [METs]). Participants are classed as 'dependent' (n = 800) or 'independent' (n = 4400); the latter category is divided arbitrarily into quartiles, based on physical activity patterns (Q1-Q4; n = 1100 for each quartile). The five groups show a graded prevalence of various morbidities, including dependency, depression, osteoporosis, fractures, hypertension, diabetes mellitus, hyperlipidaemia, ischaemic heart diseases, cerebrovascular diseases, cancer and dementia. Consequently, annual healthcare expenditures (based on 2009 published Japanese costs associated with each of these conditions) differ by about yen (¥)197 900 ($US1979) per person between dependent individuals and those in group Q1, ¥20 700 ($US207) between Q1 and Q2, ¥14 600 ($US146) between Q2 and Q3, and ¥5300 ($US53) between Q3 and Q4. Accepting a causal relationship between physical activity and health, and assuming that an increase in physical activity induces a benefit that is uniform across conditions and diseases, respective morbidity prevalences and associated healthcare costs seem likely to decrease as physical activity increases. Thus, if the physical activity of only 5% of each group could be increased by a single ranking (pedometer/accelerometer scores of 2000 steps/day and 5-10 min/day at >3 METs and/or an adjusted questionnaire score of 10 MET hours/week), one might predict average savings across this population of about ¥12 600 ($US126) per person, or 3.7%, of total medical expenses, including ¥9800 ($US98) of public nursing care insurance costs and an additional ¥2800 ($US28) of national health insurance expenditures. The impact of various changes in the prevalence of physical activity can be simulated using our model. In principle, savings should increase if more people increase their physical activity, and/or the magnitude of individual increases in physical activity is greater. Nevertheless, our analysis suggests that if even a small fraction of individuals in the three least active groups were to make a single-rank increase in their habitual physical activity as a result of focused health support and the promotion of physical activity, a significant reduction in medical expenses might be anticipated, justifying investment in preventive programmes. We now propose to test the validity of the present simulations on a national basis, obtaining accurate and objective evidence of change in individual physical activity patterns using an advanced design of pedometer/accelerometer.
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Affiliation(s)
- Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan.
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Best KL, Miller WC. Physical and leisure activity in older community-dwelling canadians who use wheelchairs: a population study. J Aging Res 2011; 2011:147929. [PMID: 21584226 PMCID: PMC3092515 DOI: 10.4061/2011/147929] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 01/04/2011] [Accepted: 02/17/2011] [Indexed: 11/30/2022] Open
Abstract
Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.
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Affiliation(s)
- Krista L. Best
- Rehabilitation Sciences Graduate Program, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, Canada V6T 2B5
| | - William C. Miller
- Rehabilitation Sciences Graduate Program, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, Canada V6T 2B5
- GF Strong Rehabilitation Centre, 4255 Laurel Street, Vancouver, Canada V5Z 2G9
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