The Association Between Objectively Measured Physical Activity and Subsequent Health Care Utilization in Older Men.
Health care utilization
Hospitalization
Objective physical activity
Older men
Step count
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
16 05 2019
16 05 2019
Historique:
received:
24
04
2017
accepted:
06
10
2017
pubmed:
18
5
2018
medline:
25
2
2020
entrez:
18
5
2018
Statut:
ppublish
Résumé
To examine the associations between objective physical activity measures and subsequent health care utilization. We studied 1,283 men (mean age 79.1 years, SD 5.3) participating in the Osteoporotic Fractures in Men Study. Participants wore a SenseWear® Pro Armband monitor for 1 week. Data was summarized as daily (i) step counts, (ii) total energy expenditure, (iii) active energy expenditure, and (iv) activity time (sedentary, ≥ light, ≥ moderate). The outcome measures of 1-year hospitalizations/duration of stay from Medicare data were analyzed with a two-part hurdle model. Covariates included age, clinical center, body mass index, marital status, depressive symptoms, medical conditions, cognitive function, and prior hospitalization. Each 1 SD = 3,092 step increase in daily step count was associated with a 34% (95% confidence interval [CI]: 19%-46%) lower odds of hospitalization in base model (age and center) and 21% (95% CI: 4%-35%) lower odds of hospitalization in fully adjusted models. Similar but smaller associations held for other physical activity measures, but these associations were not significant in fully adjusted models. Among those hospitalized, higher step count was associated with shorter total duration of acute/postacute care stays in the base model only. There was a fourfold significant difference (from model-based estimates) in predicted care days comparing those with 2,000 versus 10,000 daily steps in the base model, but only a twofold difference (not significant) in the full model. Daily step count is an easily determined measure of physical activity that may be useful in assessment of future health care burden in older men.
Sections du résumé
BACKGROUND
To examine the associations between objective physical activity measures and subsequent health care utilization.
METHODS
We studied 1,283 men (mean age 79.1 years, SD 5.3) participating in the Osteoporotic Fractures in Men Study. Participants wore a SenseWear® Pro Armband monitor for 1 week. Data was summarized as daily (i) step counts, (ii) total energy expenditure, (iii) active energy expenditure, and (iv) activity time (sedentary, ≥ light, ≥ moderate). The outcome measures of 1-year hospitalizations/duration of stay from Medicare data were analyzed with a two-part hurdle model. Covariates included age, clinical center, body mass index, marital status, depressive symptoms, medical conditions, cognitive function, and prior hospitalization.
RESULTS
Each 1 SD = 3,092 step increase in daily step count was associated with a 34% (95% confidence interval [CI]: 19%-46%) lower odds of hospitalization in base model (age and center) and 21% (95% CI: 4%-35%) lower odds of hospitalization in fully adjusted models. Similar but smaller associations held for other physical activity measures, but these associations were not significant in fully adjusted models. Among those hospitalized, higher step count was associated with shorter total duration of acute/postacute care stays in the base model only. There was a fourfold significant difference (from model-based estimates) in predicted care days comparing those with 2,000 versus 10,000 daily steps in the base model, but only a twofold difference (not significant) in the full model.
CONCLUSION
Daily step count is an easily determined measure of physical activity that may be useful in assessment of future health care burden in older men.
Identifiants
pubmed: 29771295
pii: 4399482
doi: 10.1093/gerona/glx191
pmc: PMC6521915
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
820-826Subventions
Organisme : NIA NIH HHS
ID : U01 AG042124
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG042145
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG042168
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG042140
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG027810
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG042143
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG042139
Pays : United States
Organisme : NIAMS NIH HHS
ID : U01 AR066160
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000128
Pays : United States
Informations de copyright
© The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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