Effect of body mass on future long-term care use
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.
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Posted 19 May, 2020
On 17 Aug, 2020
On 07 May, 2020
Invitations sent on 07 May, 2020
On 06 May, 2020
On 29 Oct, 2019
On 18 Feb, 2020
Received 13 Feb, 2020
Received 13 Feb, 2020
On 28 Jan, 2020
On 28 Jan, 2020
Invitations sent on 27 Nov, 2019
On 29 Oct, 2019
On 28 Oct, 2019
On 27 Oct, 2019
On 25 Oct, 2019
Effect of body mass on future long-term care use
Posted 19 May, 2020
On 17 Aug, 2020
On 07 May, 2020
Invitations sent on 07 May, 2020
On 06 May, 2020
On 29 Oct, 2019
On 18 Feb, 2020
Received 13 Feb, 2020
Received 13 Feb, 2020
On 28 Jan, 2020
On 28 Jan, 2020
Invitations sent on 27 Nov, 2019
On 29 Oct, 2019
On 28 Oct, 2019
On 27 Oct, 2019
On 25 Oct, 2019
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