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Understanding poor health behaviours as predictors of different types of hospital admission in older people: findings from the Hertfordshire Cohort Study

Lookup NU author(s): Professor Avan Sayer

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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.


Publication metadata

Author(s): Syddall HE, Westbury LD, Simmonds SJ, Robinson S, Cooper C, Sayer AA

Publication type: Article

Publication status: Published

Journal: Journal of Epidemiology & Community Health

Year: 2016

Volume: 70

Issue: 3

Pages: 292-298

Print publication date: 01/03/2016

Online publication date: 19/10/2015

Acceptance date: 02/10/2015

ISSN (print): 0143-005X

ISSN (electronic): 1470-2738

Publisher: BMJ Publishing Group

URL: http://dx.doi.org/10.1136/jech-2015-206425

DOI: 10.1136/jech-2015-206425


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