Association of physical activity with utilization of long-term care in community-dwelling older adults in Germany: results from the population-based KORA-Age observational study

• Type of Material: Article
• Authors: Kathrin Steinbeisser, Helmholtz Zentrum Munchen; Larissa Schwarzkopf, Helmholtz Zentrum Munchen; Lars Schwettmann, Helmholtz Zentrum Munchen; Michael Laxy, Emory University; Eva Grill, Ludwig-Maximilians-University Munich; Christian Rester, Technical University of Deggendorf; Annette Peters, German Research Center for Environmental Health; Hildegard Seidl, Helmholtz Zentrum Munchen
• Language: English
• Date: 2022-08-08
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12966-022-01322-z
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY
• Volume: 19
• Issue: 1
• Start Page: 102
• End Page: 102
• Grant/Funding Information: Open Access funding enabled and organized by Projekt DEAL.; The KORA research platform (KORA, Cooperative Research in the Region of Augsburg) was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria.; The KORA-Age project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713 and 01ET1003A, C) as part of the “Health in old age” program. The financial sponsors played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: Nutrition & Dietetics; Physiology; Elderly; Sports; Generalized estimating equations; Science & Technology; Gender; RISK; Active lifestyle; Nursing care; BARRIERS; Health care utilization; Life Sciences & Biomedicine; National guidelines; Health promotion; Prevention; DETERMINANTS
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Health Care Management

Abstract

Background: Physical activity (PA) is a proven strategy to prevent chronic diseases and reduce falls. Furthermore, it improves or at least maintains performance of activities of daily living, and thus fosters an independent lifestyle in older adults. However, evidence on the association of PA with relevant subgroups, such as older adults with utilization of long-term care (LTC), is sparse. This knowledge would be essential for establishing effective, need-based strategies to minimize the burden on healthcare systems due to the increasing need for LTC in old age. Methods: Data originate from the 2011/12 (t1) baseline assessment and 2016 (t2) follow-up of the population-based Cooperative Health Research in the Region of Augsburg (KORA-)Age study in southern Germany. In 4812 observations of individuals ≥65 years, the association between various types of PA (walking, exercise (i. e., subcategory of PA with the objective to improve or maintain one or more components of physical fitness), walking+exercise) and utilization of LTC (yes/no) was analyzed using generalized estimating equation logistic models. Corresponding models stratified by sex (females: 2499 observations; males: 2313 observations) examined sex-specific associations. Descriptive analyses assessed the proportion of individuals meeting the suggested minimum values in the German National Physical Activity Recommendations for older adults (GNPAR). Results: All types of PA showed a statistically significant association with non-utilization of LTC in the entire cohort. “Walking+exercise” had the strongest association with non-utilization of LTC in the entire cohort (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.39–0.70) and in males (OR: 0.41, CI: 0.26–0.65), whereas in females it was “exercise” (OR: 0.58; CI: 0.35–0.94). The proportion of individuals meeting the GNPAR was higher among those without utilization of LTC (32.7%) than among those with LTC (11.7%) and group differences were statistically significant (p ≤ 0.05). Conclusions: The GNPAR are rarely met by older adults. However, doing any type of PA is associated with non-utilization of LTC in community-dwelling older adults. Therefore, older adults should be encouraged to walk or exercise regularly. Furthermore, future PA programs should consider target-groups’ particularities to reach individuals with the highest needs for support.