Among the 127,108 participants with a mean follow up of 10 years;
– 23,094 participants (18 percent) were admitted to a nursing home.
– compared with over-60s in the low risk lifestyle group, the risk of aged care admission was 43 percent higher for those in the high risk group, and 12 percent higher for those in the medium risk group.
The association between lifestyle score and risk of aged care admission was linear, meaning that as the lifestyle score increased, the risk of admission to a nursing home decreased. However this trend differed by age and physical impairment.
– For instance, lifestyle factors were especially influential among 60-64 year olds, those in this age bracket with the unhealthiest lifestyle were more than twice as likely to be admitted to aged care than those with the healthiest lifestyle.
– All key lifestyle factors—bar diet—were independently associated with aged care admission.
– The risk of admission was highest (55 percent higher) for current smokers, compared with those who had never smoked.
The researchers emphasise that this is an observational study and as such can’t establish direct cause. The study also has some limitations.
For example, while common in large observational studies, the study relied on questionnaire data at one point in time so is unable to account for lifestyle behaviour changes over time. The reasons for aged care admissions and what coexisting health conditions were present at admission are also unknown.
And dietary assessment was only based on a few questions which assessed fruit, vegetable, fish, red and processed meat consumption, which might explain why no independent association was found between diet and nursing home admission, say the researchers.
Nevertheless, the researchers conclude that in the Australian population: “lifestyle factors are strongly associated with the risk of long-term nursing home admission in men and women older than 60 years. This evidence is an important contribution to aged care policy and might also serve as a personal motivator for lifestyle changes among younger at-risk individuals who do not want to lose their future independence and want to remain in their homes for as long as possible”.
“On a public health level this study suggests we should be looking at strategies to encourage older people to improve their lifestyle including focusing on smoking cessation, reducing sitting time, increasing physical activity and improving sleep to help reduce the burden on our aged care system,” said Dr Gibson.
