Objectively assessed physical activity and subsequent health service use of UK adults aged 70 and over: A four to five year follow up study

Objectives: To examine the associations between volume and intensity of older peoples' physical activity, with their subsequent health service usage over the following four to five years. Study Design: A prospective cohort design using baseline participant characteristics, objectively assessed physical activity and lower limb function provided by Project OPAL (Older People and Active Living). OPAL-PLUS provided data on numbers of primary care consultations, prescriptions, unplanned hospital admissions, and secondary care referrals, extracted from medical records for up to five years following the baseline OPAL data collection. Participants and Data Collection: OPAL participants were a diverse sample of 240 older adults with a mean age of 78 years. They were recruited from 12 General Practitioner surgeries from low, middle, and high areas of deprivation in a city in the West of England. Primary care consultations, secondary care referrals, unplanned hospital admissions, number of prescriptions and new disease diagnoses were assessed for 213 (104 females) of the original 240 OPAL participants who had either consented to participate in OPAL-PLUS or already died during the follow-up period. Results: In regression modelling, adjusted for socio-economic variables, existing disease, weight status, minutes of moderate-to-vigorous physical activity (MVPA) per day predicted subsequent numbers of prescriptions. Steps taken per day and MVPA also predicted unplanned hospital admissions, although the strength of the effect was reduced when further adjustment was made for lower limb function. Conclusions: Community-based programs are needed which are successful in engaging older adults in their late 70s and 80s in more walking, MVPA and activity that helps them avoid loss of physical function. There is a potential for cost savings to health services through reduced reliance on prescriptions and fewer unplanned hospital admissions. © 2014 Simmonds et al

Objectively Measured Sedentary Time and its Association With Physical Function in Older Adults

The relationship of objectively measured sedentary time (ST), frequency of breaks in ST, and lower extremity function (LEF) was investigated in a diverse sample aged ≥ 70 years (n = 217). Physical activity (PA) was assessed by accelerometry deriving moderate-vigorous PA (MVPA) minutes per registered hour (MVPA min · hr−1), registered ST (ST min · hr−1), and breaks in ST min · hr−1 (breaks · hr−1). LEF was assessed by the Short Physical Performance Battery. Univariate associations with overall LEF were MVPA (r = .523), ST (r = −.499), and breaks (r = .389). Adjusted linear regression including MVPA min · hr−1, ST min · hr−1, and breaks · hr−1 explained 41.5% of LEF variance. Each additional break · hr−1 was associated with 0.58 point increase in LEF. Breaks and MVPA had strongest independent associations with LEF. Promoting regular breaks might be useful in maintaining or increasing LEF and later life independence. This novel finding is important for the design of effective lifestyle interventions targeting older adults.</jats:p

Negative binomial regression predicting use of consultations and prescriptions based on measures of physical activity.

<p>IRR (incidence rate ratio), which is defined as <i>e</i>^B, where B is the regression coefficients.</p><p><b>Model 1</b>: adjusting a baseline covariates, including age, gender, educational attainment, IMD tertile, weight status, and number of self-reported chronic illnesses, and also GP Management System, and time lapse to follow-up;</p><p><b>Model 2</b>: additionally adjusting for lower limb function.</p

Baseline participant characteristics, percentage with a new disease diagnoses and HSU means during follow up.

1<p>IMD, Index of Multiple Deprivation-scores derived from participants' postcodes (high score indicates high level of deprivation).</p

Negative binomial regression predicting unplanned hospital admissions and referrals based on measures of physical activity.

<p>Negative binomial regression predicting unplanned hospital admissions and referrals based on measures of physical activity.</p

Follow-up time, existing disease at baseline, % (n) with new disease diagnoses, and HSU variables by physical activity and function groups.

a)<p>Low significantly different to medium and high group.</p>b)<p>Low significantly different to medium group.</p>c)<p>Medium significantly different to high group.</p>d)<p>Low significantly different to high group.</p