Effect of body mass on future long-term care use.
BMI
Elderly people
Formal care
Informal care
Long-term care
Obesity
Social care
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
17 08 2020
17 08 2020
Historique:
received:
25
10
2019
accepted:
03
08
2020
entrez:
19
8
2020
pubmed:
19
8
2020
medline:
22
12
2020
Statut:
epublish
Résumé
Obesity is a known predictor of disability and functional limitations, and, in turn, of health care use. In this study, we aim to explore whether obesity is also a significant risk factor for future long-term care use, overall and by type of care. We use multinomial logistic regression analysis on data from the English Longitudinal Study of Ageing (ELSA) for individuals aged 65 and older between 2002 and 2011. Selection issues are tackled using the rich set of control variables, exploiting the data's longitudinal structure and accounting for loss to follow-up (including death). Control factors include health-related behaviours (physical activity, alcohol and tobacco consumption), functional limitations (related to ADLs, iADLs and mobility) and specific existing health conditions, notably diabetes, high blood pressure and cardio-vascular diseases. We find that obese older people are 25% (p < 0.01) more likely to receive informal or privately-paid care in the future, but this does not hold for formal care. This is an additional direct effect after controlling for a wide range of health conditions and functional limitations. We document some evidence that this effect is due to the development of new functional limitations. Sensitivity analyses suggest that the results are robust to controlling for prediabetes, subjective health, depression, or unobserved heterogeneity. This study provides new evidence of a positive direct effect of obesity on the future use of long-term care services. Accordingly, it adds evidence of further economic benefits to any overall evaluation of policies to promote a healthy weight in the population, particularly in the older population.
Sections du résumé
BACKGROUND
Obesity is a known predictor of disability and functional limitations, and, in turn, of health care use. In this study, we aim to explore whether obesity is also a significant risk factor for future long-term care use, overall and by type of care.
METHODS
We use multinomial logistic regression analysis on data from the English Longitudinal Study of Ageing (ELSA) for individuals aged 65 and older between 2002 and 2011. Selection issues are tackled using the rich set of control variables, exploiting the data's longitudinal structure and accounting for loss to follow-up (including death). Control factors include health-related behaviours (physical activity, alcohol and tobacco consumption), functional limitations (related to ADLs, iADLs and mobility) and specific existing health conditions, notably diabetes, high blood pressure and cardio-vascular diseases.
RESULTS
We find that obese older people are 25% (p < 0.01) more likely to receive informal or privately-paid care in the future, but this does not hold for formal care. This is an additional direct effect after controlling for a wide range of health conditions and functional limitations. We document some evidence that this effect is due to the development of new functional limitations. Sensitivity analyses suggest that the results are robust to controlling for prediabetes, subjective health, depression, or unobserved heterogeneity.
CONCLUSIONS
This study provides new evidence of a positive direct effect of obesity on the future use of long-term care services. Accordingly, it adds evidence of further economic benefits to any overall evaluation of policies to promote a healthy weight in the population, particularly in the older population.
Identifiants
pubmed: 32807108
doi: 10.1186/s12877-020-01688-4
pii: 10.1186/s12877-020-01688-4
pmc: PMC7433070
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
293Subventions
Organisme : National Institute for Health Research (UK_
ID : PRP 100/0001
Pays : International
Références
Int J Obes (Lond). 2014 Jun;38(6):857-64
pubmed: 24247373
J Health Econ. 2008 Jan;27(1):134-56
pubmed: 17462764
Arch Intern Med. 2007 Apr 23;167(8):774-80
pubmed: 17452539
J Health Econ. 2004 Nov;23(6):1159-80
pubmed: 15556241
Obes Res. 2005 Aug;13(8):1307-10
pubmed: 16129711
N Engl J Med. 1999 Oct 7;341(15):1097-105
pubmed: 10511607
Lancet. 2011 Aug 27;378(9793):815-25
pubmed: 21872750
Am J Epidemiol. 1998 Mar 15;147(6):516-22
pubmed: 9521177
Am J Epidemiol. 1990 Sep;132(3):501-13
pubmed: 2389754
J Health Econ. 2011 Jul;30(4):719-29
pubmed: 21641063
Med Care. 2014 Jul;52(7):658-63
pubmed: 24926714
Int J Cancer. 2001 Feb 1;91(3):421-30
pubmed: 11169969
Soc Sci Med. 2008 Sep;67(6):1002-8
pubmed: 18579273
Health Aff (Millwood). 2004 Mar-Apr;23(2):199-205
pubmed: 15046144
Br Med Bull. 2011;97:169-96
pubmed: 21325341
Obes Res. 2002 Aug;10(8):816-23
pubmed: 12181391
J Aging Res. 2013;2013:905094
pubmed: 23691319
BMC Public Health. 2009 Mar 25;9:88
pubmed: 19320986
Econ Hum Biol. 2015 Apr;17:42-58
pubmed: 25637887
Econ Hum Biol. 2008 Mar;6(1):127-42
pubmed: 17921075
JAMA. 1998 Mar 18;279(11):839-46
pubmed: 9515998
Diabetes Care. 1994 Sep;17(9):961-9
pubmed: 7988316
JAMA. 2001 Aug 22-29;286(8):921-9
pubmed: 11509056
J Public Health (Oxf). 2011 Dec;33(4):527-35
pubmed: 21562029
Obesity (Silver Spring). 2006 Aug;14(8):1472-8
pubmed: 16988091