Impact of physical activity and performance on medical care costs among the Japanese elderly

Aim: Physical activity (PA) is known to be inversely associated with medical care costs. The amount of PA is strongly associated with the level of physical performance among the elderly population. Therefore, it is possible that known relation between PA and medical care merely shows the relation between physical performance and medical care. To know whether PA itself relates to medical care, considering physical performance is necessary. The aim of this study was to ascertain the impact of PA on medical care expenditure by considering the physical performance in an elderly community-dwelling population. Methods: We investigated 483 subjects who did not have any history of diseases relating to limited PA and who completed both a self-administered questionnaire including questions on PA and underwent a physical performance measurement. We ascertained the total medical care costs through a computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance Association. Results: The physical performance was positively associated with their level of PA. After multivariate adjustment for covariables including the levels of physical performance, the per capita medical care costs were found to be $US 827.3 (598.0-1056.7) (mean, 95% confidence interval), $US 711.1 (476.4-945.8) and $US 702.0 (461.6-942.4) (P for linear trend = 0.02) per month for those who had the lowest, average and the highest level of PA, respectively. Conclusion: This prospective study indicates that a higher level of PA is associated with lower medical care costs among the Japanese elderly irrespective of physical performance. Geriatr Gerontol Int 2011; 11: 157-165.