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Medicare Costs of Physical Inactivity in Older Adults

Russell Luepker, Univ of Minnesota, Minneapolis, MN, et. al.
Presented Wednesday, November 20, 2002, at the AHA Annual Conference
Publishing ID: 3509, Abstract ID: 115044

The benefits of regular physical activity on health and well-being are well studied and widely recommended. However, there are few studies of the cost implications of physical activity or sedentary lifestyle. Older adults are among the least physically active segment of the US population partly due to physical activity limiting diseases but also among healthy able individuals. The NHLBI Cardiovascular Health Study (CHS) [group] was examined to characterize physical activity at baseline and associations with five-year Medicare costs (all hospital, physician and outpatient medical expenditures).

The CHS [group] included 824 men and 1330 women greater than or equal to 65 years who described their health as good or excellent and had no exercise limiting conditions. Exercise measures included: (1) Physical activity Intensity, (2) Kcal/week in physical activity, and (3) Blocks walked/week. Only subjects with fee-for-service insurance were included. Data were adjusted for age and sex. Average Medicare costs for this healthy group were $11,300 for the five year [study period].

Compared to sedentary subjects, older adults with low, medium, and high regular physical activity had significantly (p<0.01) lower costs of $6800, $6800, and $6200, respectively. Older adults with regular physical activity, expressed as Kcal/week, had lower costs with rising energy expenditure. Compared to the sedentary, the 2nd, 3rd and 4th quartiles had $4300, $4800, and $6200 lower costs (significant, p<0.001) . Blocks walked/week demonstrated similar trends, with older adults in the 2nd, 3rd, and 4th quartiles having lower costs at $300, $1300 and $3100 [lower], respectively. This [last] association failed to reach statistical significance. (Observational studies such as CHS are susceptible to the challenges to the measurement of physical activity and self selection of those who do exercise.)  There is evidence from this study that regular physical activity may have benefits for health care costs as well as [for] health.  

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