An unhealthy lifestyle may increase your likelihood of needing assisted living services when you get older, according to a new study by researchers from the University of Sydney.
The peer-reviewed study, published in the Journal of Epidemiology and Community Health, examined how factors such as smoking, physical activity, sitting, sleep, and diet affected the chances of people requiring admission to nursing homes.
The study examined 127,108 men and women aged 60 and older who had taken part in the Sax Institute’s 45 and Up study. As part of the study, participants were required to report on their lifestyle behaviors and were given a score based on their reports. The best score was given to those who were active for more than 300 minutes a week, did not smoke, slept between seven to nine hours a day, sat less than seven hours a day, and followed a diet with a high intake of fruit and vegetables and a low intake of red and processed meat.
The participants were placed into three groups based on their scores: low risk, medium risk, and high risk. One in seven of the participants was found to be in the high-risk group.
During a median follow-up of about 10 years, 18% of the participants were admitted to a nursing home, with participants in the high-risk group being 43% more likely to be admitted than those in the low-risk group. Participants in the medium-risk group were 12% more likely to be admitted than the low-risk group.
An elderly woman sits in the recreation room of a retirement home as visits have been restricted due to the coronavirus disease (COVID-19) concerns in Grevenbroich (credit: REUTERS)The researchers found that all of the lifestyle behaviors except for diet were independently linked to an increased risk of nursing home admission, with age and physical impairment affecting how much of an impact they had.
The limitations of the study
The researchers stressed, however, that they did not have access to records stating the exact reason for nursing home admission for each participant nor the presence of other conditions at the time of admission. The study also did not take into account social isolation and loneliness, which have been shown to have an effect on the mental and physical health of older adults.
The lifestyle factors were also self-reported by the participants and only measured once, meaning there was no way to track potential lifestyle changes over the observation period. The questionnaire for dietary lifestyle choices also was not comprehensive and could explain why researchers were unable to find an independent link between diet and a higher risk of nursing home admission.
First study to examine the link between lifestyle behaviors and need for nursing home care
“We know that factors like poor sleep and inactivity increase people’s risk of developing diseases like dementia and diabetes, but this is the first study to look at the independent and combined impact these established and emerging lifestyle behaviors have on a person’s risk of admission into aged care,” said Dr. Alice Gibson of the University of Sydney’s Charles Perkins Centre and Menzies Centre for Health Policy and Economics.
“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,” added Gibson.
“You can still be considered ‘low-risk’ overall even if you’re ‘high-risk’ in one behavior,” Gibson noted. “Another positive message from our research is that a person’s body mass index has no link to the risk of nursing home admission. This supports the notion in wider literature that some excess weight can be protective in older age.”
