Older Australians can reduce their time spent in hospital by walking an extra 4300 steps per day, according to research published in the Medical Journal of Australia.
The study, undertaken by Dr Ben Ewald and colleagues from the Centre for Clinical Epidemiology and Biostatistics at the University of Newcastle, found that an increase in step count from 4500 to 8800 steps per day was associated with 0.36 fewer hospital bed-days per person per year.
Participants in the study wore pedometers for one week during 2005-2007. Their hospital data from recruitment to 31 March 2015 were analysed, with a mean follow-up time of 8.2 years. Complete data for 2110 people, all aged 55 or more, were available for analysis.
There was a statistically significant reduction in the number of hospital bed-days associated with higher step counts; the overall estimated number of bed-days per year of follow-up decreased by 9% for each 1000-step increase in daily step count. Disease-specific reductions were significant for cancer and diabetes, but not for cardiovascular disease.
After adjusting for age, sex, numbers of medications and comorbidities, smoking and alcohol status, and education, the difference between 4500 and 8800 steps per day was 0.36 bed-days per person per year. If analysis was restricted to hospital admissions beyond the first 2 years of follow-up (to control for the possibility that illness causes people to be less active), the difference was still 0.29 bed-days per person per year.
"The cost of a day in hospital in Australia in 2012-13 was $1895, so $550 can potentially be saved annually for each person who increases their physical activity by an achievable 4300 steps per day, the authors wrote. "These steps can be accumulated as many brief activities throughout the day, or as steady walking for about 3 kilometres. Previous investigation of the dose - response curves for various health indicators in older people has shown that the steepest part of the curve is at the lower end of activity. Moving from 3000 to 5000 steps per day is of greater benefit than moving from 8000 to 10 000 steps."
The authors concluded that: "Health interventions and urban design features that encourage walking could have a substantial effect on the need for hospital care, and should be features of health policy."
In a linked editorial, Alfred Deakin Professor Jo Salmon and Dr Nicky Ridgers from the Institute for Physical Activity and Nutrition at Deakin University in Melbourne wrote that wearable activity monitors, such as Fitbit, Garmin and the Apple Watch, had "the potential to enhance the likelihood of maintaining increases in physical activity in the longer term".
"Further investigation of wearable technology is needed, particularly in different population groups, with the aim of identifying the key factors for enhancing sustained changes in physical activity," they wrote. "We need to identify how these devices can be integrated into clinical practice in order to improve health outcomes. But for health practitioners with sedentary patients looking for assistance with becoming more active, a wearable activity monitor would be a good first step."
Article: Daily step count and the need for hospital care in subsequent years in a community-based sample of older Australians, Ben D Ewald, Christopher Oldmeadow and John R Attia, Medical Journal of Australia, doi: 10.5694/mja16.00640, published 20 February 2017.