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Background: Obesity is a known predictor of disability and functional limitations, and, in turn, of health care use. In this study, we aim to explore whether obesity is also a significant risk factor for future long-term care use, overall and by type of care.
Methods: We use multinomial logistic regression analysis on data from the English Longitudinal Study of Ageing (ELSA) for individuals aged 65 and older between 2002 and 2011. Selection issues are tackled using the rich set of control variables, exploiting the data’s longitudinal structure and accounting for loss to follow-up (including death). Control factors include health-related behaviours (physical activity, alcohol and tobacco consumption), functional limitations (related to ADLs, iADLs and mobility) and specific existing health conditions, notably diabetes, high blood pressure and cardio-vascular diseases.
Results: We find that obese older people are 25% (p<0.01) more likely to receive informal or privately paid care in the future, but this does not hold for formal care. This is an additional direct effect after controlling for a wide range of health conditions and functional limitations. We document some evidence that this effect is due to the development of new functional limitations. Sensitivity analyses suggest that the results are robust to controlling for prediabetes, subjective health, depression, or unobserved heterogeneity.
Conclusions: This study provides new evidence of a positive direct effect of obesity on the future use of long-term care services. Accordingly, it adds evidence of further economic benefits to any overall evaluation of policies to promote a healthy weight in the population, particularly in the older population.
Keywords
long-term care, elderly people, formal care, social care, informal care, BMI, physical activity, obesity
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CURRENT STATUS: Published
View the published article at BMC Geriatrics.
Version 2
Posted 19 May, 2020
No community comments so far
Editor assigned
On 07 May, 2020
Reviewers invited
Invitations sent on 07 May, 2020
Editor invited
On 06 May, 2020
Submission checks complete
On 29 Oct, 2019
No comments provided
Editorial decision: Major revision
On 18 Feb, 2020
Review #2 received
Received 13 Feb, 2020
Review #1 received
Received 13 Feb, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Reviewer #2 agreed
On 28 Jan, 2020
Reviewers invited
Invitations sent on 27 Nov, 2019
Submission checks complete
On 29 Oct, 2019
Editor assigned
On 28 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 25 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
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See the published version of this preprint at BMC Geriatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Geriatrics.
Version 2
Posted 19 May, 2020
No community comments so far
Editor assigned
On 07 May, 2020
Reviewers invited
Invitations sent on 07 May, 2020
Editor invited
On 06 May, 2020
Submission checks complete
On 29 Oct, 2019
No comments provided
Editorial decision: Major revision
On 18 Feb, 2020
Review #2 received
Received 13 Feb, 2020
Review #1 received
Received 13 Feb, 2020
Reviewer #1 agreed
On 28 Jan, 2020
Reviewer #2 agreed
On 28 Jan, 2020
Reviewers invited
Invitations sent on 27 Nov, 2019
Submission checks complete
On 29 Oct, 2019
Editor assigned
On 28 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 25 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Obesity is a known predictor of disability and functional limitations, and, in turn, of health care use. In this study, we aim to explore whether obesity is also a significant risk factor for future long-term care use, overall and by type of care.
Methods: We use multinomial logistic regression analysis on data from the English Longitudinal Study of Ageing (ELSA) for individuals aged 65 and older between 2002 and 2011. Selection issues are tackled using the rich set of control variables, exploiting the data’s longitudinal structure and accounting for loss to follow-up (including death). Control factors include health-related behaviours (physical activity, alcohol and tobacco consumption), functional limitations (related to ADLs, iADLs and mobility) and specific existing health conditions, notably diabetes, high blood pressure and cardio-vascular diseases.
Results: We find that obese older people are 25% (p<0.01) more likely to receive informal or privately paid care in the future, but this does not hold for formal care. This is an additional direct effect after controlling for a wide range of health conditions and functional limitations. We document some evidence that this effect is due to the development of new functional limitations. Sensitivity analyses suggest that the results are robust to controlling for prediabetes, subjective health, depression, or unobserved heterogeneity.
Conclusions: This study provides new evidence of a positive direct effect of obesity on the future use of long-term care services. Accordingly, it adds evidence of further economic benefits to any overall evaluation of policies to promote a healthy weight in the population, particularly in the older population.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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