title: Lifestyle risk factors predict healthcare costs in an aging cohort.
abstract: BACKGROUND
  While the U.S. elderly population uses a disproportionate amount of healthcare resources, there is limited knowledge from prospective studies regarding the impact of lifestyle-related factors on costs in this group. The association was examined between smoking, drinking, exercise, body mass index (BMI), and changes in these risk factors, and healthcare costs after 4 years among 68- to 95-year-olds.
  
  
  METHODS
  A total of 1323 participants completed annual surveys providing information on lifestyle factors (1986-1994) and health utilization (1994-1998). Healthcare costs in nine categories were ascertained from validated utilization. The relationships between risk factors and costs were examined in 2004 using linear regression models.
  
  
  RESULTS
  Fewer cigarette pack-years and lower BMI were the most significant predictors of lower total costs in 1998 (p<0.001), controlling for baseline sociodemographic factors, costs, and conditions. Associations with smoking were strongest for hospitalizations, diagnostic tests, and physician and nursing-home visits. Those who reduced smoking by one pack per day experienced cost savings of 1160 dollars (p<0.05). The costs for normal weight compared to minimally obese seniors were approximately 1548 dollars lower, with diagnostic testing, physician visits, and medications accounting for much of this difference. Daily walking, measured at baseline, also predicted lower costs for hospitalizations and diagnostic testing.
  
  
  CONCLUSIONS
  Seniors who were leaner, smoked fewer cigarettes over a lifetime, reduced their smoking, or walked farther had significant subsequent cost savings compared to those with less-healthy lifestyle-related habits.
authors.affiliation: Center for Health Services Research in Primary Care, University of California-Davis, Davis, California, USA.
authors.forename: J Paul
authors.initials: JP
authors.lastname: Leigh
authors.forename: Helen B
authors.initials: HB
authors.lastname: Hubert
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Romano
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005102:Health Expenditures; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D012307:Risk Factors; D014481:United States