Leisure time physical activity throughout adulthood is associated with lower medicare costs: Evidence from the linked nih-aarp diet and health study cohort

TY - JOUR

T1 - Leisure time physical activity throughout adulthood is associated with lower medicare costs

T2 - Evidence from the linked nih-aarp diet and health study cohort

AU - Coughlan, Diarmuid

AU - Saint-Maurice, Pedro F.

AU - Carlson, Susan A.

AU - Fulton, Janet

AU - Matthews, Charles E.

N1 - Funding Information: Acknowledgements The authors thank the participants of the NIH-AARP Diet and Health Study who allowed for linkage to their Medicare records. Thanks also to John Mullahy (University of Wisconsin) and John Wildman (Newcastle University, UK) for econometric advice; David Leonard (The Cooper Institute Dallas, Texas) and Maryam Doroudi (NCI) for research design support. DC would like to acknowledge the support of the Cancer Prevention Fellowship Program of the NCI and the Health Research Board in Ireland. Contributors CEM, PFS-M and DC contributed to the acquisition of data, DC, PFS-M, SAC, JF and CEM were involved in the conception and design of this study, DC and PFS-M conducted the analyses, all authors were involved in interpretation of the data; DC prepared the first draft and all authors critically reviewed and revised this several times, with addition of important intellectual content. All authors gave final approval of the version to be submitted. Funding Information: Funding This research was supported (in part) by the Intramural Research Program of the NIH, National Cancer Institute. Publisher Copyright: © Author(s) (or their employer(s)) 2021.

PY - 2021/3/5

Y1 - 2021/3/5

N2 - 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 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.

AB - 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 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.

KW - Epidemiology

KW - Longevity

KW - Physical activity

KW - Public health

UR - http://www.scopus.com/inward/record.url?scp=85113372538&partnerID=8YFLogxK

U2 - 10.1136/bmjsem-2021-001038

DO - 10.1136/bmjsem-2021-001038

M3 - Article

AN - SCOPUS:85113372538

SN - 2055-7647

VL - 7

JO - BMJ Open Sport and Exercise Medicine

JF - BMJ Open Sport and Exercise Medicine

IS - 1

M1 - e001038

ER -