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Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort

Lookup NU author(s): Dr Diarmuid CoughlanORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background: There is limited information about the association between long-term leisure time physical activity (LTPA) participation and healthcare costs. The purpose of this study was to investigate the association between LTPA over adulthood with later life healthcare costs in the USA.Methods: Using Medicare claims data (between 1999 and 2008) linked to the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, we examined associations between nine trajectories of physical activity participation throughout adulthood with Medicare costs.Results: Compared with adults who were consistently inactive from adolescence into middle age, average annual healthcare costs were significantly lower for maintainers, adults who maintained moderate (-US$1350 (95% CI: -US$2009 to -US$690) or -15.9% (95% CI: -23.6% to -8.1%)) or high physical activity levels (-US$1200 (95% CI: -US$1777 to -US$622) or -14.1% (95% CI: -20.9% to -7.3%)) and increasers, adults who increased physical activity levels in early adulthood (-US$1874 (95% CI: US$2691 to -US$1057) or -22.0% (95% CI: -31.6% to -12.4%)) or in middle age (-US$824 (95% CI: -US$1580 to -US$69 or -9.7% (95% CI -18.6% to -0.8%)). For the four trajectories where physical activity decreased, the only significant difference was for adults who increased physical activity levels during early adulthood with a decline in middle age (-US$861 (95% CI:-US$1678 to -US$45) or -10.1% (95% CI: -19.7% to -0.5%)).Conclusion: Our analyses suggest the healthcare cost burden in later life could be reduced through promotion efforts supporting physical activity participation throughout adulthood.

Publication metadata

Author(s): Coughlan D, Saint-Maurice PF, Carlson SA, Fulton J, Matthews CE

Publication type: Article

Publication status: Published

Journal: BMJ Open Sport & Exercise Medicine

Year: 2021

Volume: 7

Issue: 1

Print publication date: 05/03/2021

Online publication date: 05/03/2021

Acceptance date: 15/02/2021

Date deposited: 25/10/2021

ISSN (electronic): 2055-7647

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjsem-2021-001038

PubMed id: 33768963


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Funder referenceFunder name
Intramural Research Program of the NIH, National Cancer Institute