Body mass, physical activity and future long-term care use

Obesity and physical activity rates are known to be strong predictors of disability and functional limitations, and in turn use of health care. In this study we aim to explore whether obesity and physical activity are also significant risk factors for future long-term care need (both informal and formal care). We use regression analysis of data from the English Longitudinal Study of Ageing (ELSA) between 2002 to 2011 to addres this aim. Selection issues are tackled using the rich set of control variables in ELSA; exploiting the longitudinal structure of the data; and accounting for loss to follow-up (including death). Control factors include: impairment (ADLs) and specific existing health conditions – notably diabetes, high blood pressure, and CVD. We find that obese older people are 25% more likely to be in receipt of informal or privately paid care in two year’s time, but this does not hold for formal care. People who are physically active are 38% less likely to be using any care two years later, with the strongest effect for formal care use. Sensitivity analysis suggests that the results are not driven by either prediabetes, or a link between obesity and subjective health and depression, or unobserved factors.