title: Objectively assessed physical activity and subsequent health service use of UK adults aged 70 and over: a four to five year follow up study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  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.
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom.
authors.forename: Bethany
authors.initials: B
authors.lastname: Simmonds
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom; School of Sport & Exercise Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fox
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Davis
authors.affiliation: Graduate Institute of Sports and Health, National Changhua University of Education, Changhua City, Changua, Taiwan.
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Ku
authors.affiliation: Department of Health and Applied Social Sciences, University of the West of England, Bristol, United Kingdom.
authors.forename: Selena
authors.initials: S
authors.lastname: Gray
authors.affiliation: Sport and Health Sciences, Exeter University, Exeter, United Kingdom.
authors.forename: Melvyn
authors.initials: M
authors.lastname: Hillsdon
authors.affiliation: The School of Social and Community Medicine, The University of Bristol, Bristol, United Kingdom.
authors.forename: Debbie
authors.initials: D
authors.lastname: Sharp
authors.affiliation: Department for Health, The University of Bath, Bath, United Kingdom.
authors.forename: Afroditi
authors.initials: A
authors.lastname: Stathi
authors.affiliation: School of Sport & Exercise Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Janice
authors.initials: J
authors.lastname: Thompson
authors.affiliation: Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom.
authors.forename: Joanna
authors.initials: J
authors.lastname: Coulson
authors.affiliation: The School of Social and Community Medicine, The University of Bristol, Bristol, United Kingdom.
authors.forename: Tanya
authors.initials: T
authors.lastname: Trayers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England; D015444:Exercise / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D008991:Monitoring, Physiologic; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D013997:Time Factors; D016138:Walking / Q000502:physiology