Holly E Syddall1, Leo D Westbury1, Shirley J Simmonds1, Sian Robinson2, Cyrus Cooper3, Avan Aihie Sayer4. 1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 2. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. 3. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. 4. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK NIHR Collaboration for Leadership in Applied Health Research and Care: Wessex, University of Southampton,Southampton, UK Institute for Ageing and Institute of Health & Society, Newcastle University, Newcastle, UK.
Abstract
BACKGROUND: Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown. METHODS: 2997 community-dwelling men and women (aged 59-73) participated in the Hertfordshire Cohort Study (HCS). We scored (from 0 to 4) number of poor health behaviours engaged in at baseline (1998-2004) out of: current smoking, high weekly alcohol, low customary physical activity and poor diet. We linked HCS with Hospital Episode Statistics and mortality data to 31/03/2010 and analysed associations between the score and risk of different types of hospital admission: any; elective; emergency; long stay (>7 days); 30-day readmission (any, or emergency). RESULTS: 32%, 40%, 20% and 7% of men engaged in 0, 1, 2 and 3/4 poor health behaviours; corresponding percentages for women 51%, 38%, 9%, 2%. 75% of men (69% women) experienced at least one hospital admission. Among men and women, increased number of poor health behaviours was strongly associated (p<0.01) with greater risk of long stay and emergency admissions, and 30-day emergency readmissions. Hazard ratios (HRs) for emergency admission for 3/4 poor health behaviours in comparison with none were: men, 1.37 (95% CI 1.11 to 1.69); women, 1.84 (95% CI 1.22 to 2.77). Associations were unaltered by adjustment for age, body mass index and comorbidity. CONCLUSIONS: Clustered poor health behaviours are associated with increased risk of hospital admission among older people in the UK. Lifecourse interventions to reduce number of poor health behaviours could have substantial beneficial impact on health and use of healthcare in later life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Rates of hospital admission are increasing, particularly among older people. Poor health behaviours cluster but their combined impact on risk of hospital admission among older people in the UK is unknown. METHODS: 2997 community-dwelling men and women (aged 59-73) participated in the Hertfordshire Cohort Study (HCS). We scored (from 0 to 4) number of poor health behaviours engaged in at baseline (1998-2004) out of: current smoking, high weekly alcohol, low customary physical activity and poor diet. We linked HCS with Hospital Episode Statistics and mortality data to 31/03/2010 and analysed associations between the score and risk of different types of hospital admission: any; elective; emergency; long stay (>7 days); 30-day readmission (any, or emergency). RESULTS: 32%, 40%, 20% and 7% of men engaged in 0, 1, 2 and 3/4 poor health behaviours; corresponding percentages for women 51%, 38%, 9%, 2%. 75% of men (69% women) experienced at least one hospital admission. Among men and women, increased number of poor health behaviours was strongly associated (p<0.01) with greater risk of long stay and emergency admissions, and 30-day emergency readmissions. Hazard ratios (HRs) for emergency admission for 3/4 poor health behaviours in comparison with none were: men, 1.37 (95% CI 1.11 to 1.69); women, 1.84 (95% CI 1.22 to 2.77). Associations were unaltered by adjustment for age, body mass index and comorbidity. CONCLUSIONS: Clustered poor health behaviours are associated with increased risk of hospital admission among older people in the UK. Lifecourse interventions to reduce number of poor health behaviours could have substantial beneficial impact on health and use of healthcare in later life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
Cohort studies; Epidemiology of ageing; HEALTH BEHAVIOUR; Life course epidemiology; NHS
Authors: Elizabeth A Spencer; Kirstin L Pirie; Richard J Stevens; Valerie Beral; Anna Brown; Bette Liu; Jane Green; Gillian K Reeves Journal: Eur J Epidemiol Date: 2008-11-18 Impact factor: 8.082
Authors: Scott A McDonald; Sharon J Hutchinson; Sheila M Bird; Lesley Graham; Chris Robertson; Peter R Mills; Peter Hayes; John F Dillon; David J Goldberg Journal: Addiction Date: 2009-04 Impact factor: 6.526
Authors: Kay-Tee Khaw; Nicholas Wareham; Sheila Bingham; Ailsa Welch; Robert Luben; Nicholas Day Journal: PLoS Med Date: 2008-01-08 Impact factor: 11.069
Authors: Sarah Jane Metrustry; Ville Karhunen; Mark H Edwards; Cristina Menni; Thomas Geisendorfer; Anja Huber; Christian Reichel; Elaine M Dennison; Cyrus Cooper; Tim Spector; Marjo-Riitta Jarvelin; Ana M Valdes Journal: PLoS One Date: 2018-03-22 Impact factor: 3.240
Authors: Andreas Höhn; Lisbeth Aagaard Larsen; Daniel Christoph Schneider; Rune Lindahl-Jacobsen; Roland Rau; Kaare Christensen; Anna Oksuzyan Journal: BMJ Open Date: 2018-07-17 Impact factor: 2.692