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. Citation: Simmonds B, Fox K, Davis M, Ku P-W, Gray S, et al. (2014) Objectively Assessed Physical Activity and Subsequent Health Service Use of UK Adults Aged 70 and Over: A Four to Five Year Follow Up Study. PLoS ONE 9(5): e97676. doi:10.1371/journal.pone. 0097676 Editor: Linda Chao, University of California, San Francisco, United States of America Received August 20, 2013; Accepted April 23, 2014; Published May 27, 2014 Copyright: 2014 Simmonds et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This follow-up work (OPAL-PLUS) was supported by The Dunhill Medical Trust grant number R200/0511 with additional support from the Avon Primary Care Research Collaborative and the South West General Practitioners Trust. Project OPAL provided the baseline data and was funded by Phase 1 of the National Prevention Research Initiative (http://www.npri.org.uk; grant No. G0501312) that was supported by the British Heart Foundation, Cancer Research UK, Department of Health, Diabetes UK, Economic and Social Research Council, Medical Research Council, Research and Development Office for the Northern Ireland Health and Social Services, Chief Scientist Office, Scottish Executive Health Department, Welsh Assembly Government, and World Cancer Research Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: bethany.simmonds@bristol.ac. uk ¤ Current address: University Hospitals Bristol, Department of Rheumatology, Bristol Royal Infirmary, Bristol, United Kingdom