title: Daily step count and the need for hospital care in subsequent years in a community-based sample of older Australians.
abstract: OBJECTIVE
  To determine the extent to which physical activity reduces the number of hospital bed-days for Australians over 55, using an objective measure of activity.
  
  
  METHODS
  9784 Newcastle residents aged 55 years or more were invited to participate. 3253 responders were eligible and wore pedometers for one week during 2005-2007; their hospital data from recruitment to 31 March 2015 were analysed (mean follow-up time: 8.2 years). Complete data for 2110 people were available for analysis.
  
  
  METHODS
  Mean annual hospital bed-days, according to individual step count.
  
  
  RESULTS
  There was a statistically significant reduction in the number of hospital bed-days associated with higher step counts; the incidence rate ratio per extra 1000 steps per day at baseline was 0.91 (95% CI, 0.90-0.94). The disease-specific reductions were significant for admissions for cancer and diabetes, but not for cardiovascular disease. The difference between 4500 and 8800 steps per day (the upper and lower quartile boundaries for step count) was 0.36 bed-days per person per year, after adjusting for age, sex, number of medications, number of comorbidities, smoking and alcohol status, and education. When analysis was restricted to hospital admissions after the first 2 years of follow-up, the difference was 0.29 bed-days per person per year.
  
  
  CONCLUSIONS
  More active people require less hospital care, and an achievable extra 4300 steps per day would result in an average of one less day in hospital for each 3 years of life.
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW ben.ewald@newcastle.edu.au.
authors.forename: Ben D
authors.initials: BD
authors.lastname: Ewald
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW.
authors.forename: Christopher
authors.initials: C
authors.lastname: Oldmeadow
authors.affiliation: Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW.
authors.forename: John R
authors.initials: JR
authors.lastname: Attia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001315:Australia; D015444:Exercise; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D009517:New South Wales; D016138:Walking / Q000502:physiology*