Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort

Diarmuid Coughlan; Pedro F Saint-Maurice; Susan A Carlson; Janet Fulton; Charles E Matthews

doi:10.1136/bmjsem-2021-001038

Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort

BMJ Open Sport Exerc Med. 2021 Mar 5;7(1):e001038. doi: 10.1136/bmjsem-2021-001038. eCollection 2021.

Authors

Diarmuid Coughlan^{1

2}, Pedro F Saint-Maurice³, Susan A Carlson⁴, Janet Fulton⁴, Charles E Matthews³

Affiliations

¹ Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
² Surveillance Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
³ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
⁴ Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Abstract

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 between 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.

Keywords: epidemiology; longevity; physical activity; public health.