Impact of the medical fitness model on long term health outcomes in older adults

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dc.contributor.authorBrar, Ranveer
dc.contributor.authorKatz, Alan
dc.contributor.authorFerguson, Thomas
dc.contributor.authorWhitlock, Reid
dc.contributor.authorDi Nella, Michelle
dc.contributor.authorBohm, Clara
dc.contributor.authorRigatto, Claudio
dc.contributor.authorKomenda, Paul
dc.contributor.authorBoreskie, Sue
dc.contributor.authorSolmundson, Carrie
dc.contributor.authorKosowan, Leanne
dc.contributor.authorTangri, Navdeep
dc.date.accessioned2024-09-03T14:34:39Z
dc.date.available2024-09-03T14:34:39Z
dc.date.issued2024-08-20
dc.date.updated2024-09-01T03:21:21Z
dc.description.abstractBackground Physical inactivity is common among older adults and is associated with poor health outcomes. Medical fitness facilities provide a medically focused approach to physical fitness and can improve physical activity in their communities. This study aimed to assess the relationship between membership in the medical fitness model and all-cause mortality, health care utilization, and major adverse cardiac events in older adults. Methods A propensity weighted retrospective cohort study linked individuals that attended medical fitness facilities to provincial health administrative databases. Older adults who had at least 1 year of health coverage from their index date between January 1st, 2005 to December 31st 2015 were included. Controls were assigned a pseudo-index date at random based on the frequency distribution of index dates in members. Members were stratified into low frequency attenders (< 1 Weekly Visits) and regular frequency attenders (> 1 Weekly Visits). Time to event models estimated the hazard ratios (HRs) for risk of all-cause mortality and major adverse cardiac event. Negative binomial models estimated the risk ratios (RRs) for risk of hospitalizations, outpatient primary care visits and emergency department visits. Results Among 3,029 older adult members and 91,734 controls, members had a 45% lower risk of all-cause mortality (HR: 0.55, 95% CI: 0.50 – 0.61), 20% lower risk of hospitalizations (RR: 0.80, 95% CI: 0.75 – 0.84), and a 27% (HR: 0.72, 95% CI: 0.66 – 0.77), lower risk of a major adverse cardiovascular event. A dose–response effect with larger risk reductions was associated with more frequent attendance as regular frequency attenders were 4% more likely to visit a general practitioner for a routine healthcare visit (RR: 1.04, 95% CI: 1.01 – 1.07), but 23% less likely to visit the emergency department (RR: 0.87, 95% CI: 0.82 – 0.92). Conclusions Membership at a medical fitness facility was associated with a decreased risk of mortality, health care utilization and cardiovascular events. The medical fitness model may be an alternative approach for public health strategies to promote positive health behaviors in older adult populations.
dc.identifier.citationBMC Geriatrics. 2024 Aug 20;24(1):695
dc.identifier.doi10.1186/s12877-024-05208-6
dc.identifier.urihttp://hdl.handle.net/1993/38485
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectMedical fitness facility
dc.subjectHealth care utilization
dc.subjectMortality
dc.subjectMace
dc.titleImpact of the medical fitness model on long term health outcomes in older adults
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Community Health Sciences
oaire.citation.issue695
oaire.citation.titleBMC Geriatrics
oaire.citation.volume24
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