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Medicare beneficiaries 4242627 and health care expenditures 242627 are less often the focus of this research. To date, the authors could find no published research studies investigating the prevalence of PA levels and the association with health benefits among older adults with Medicare Supplement plans ie, Medigap.
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Thus, the primary objective of this study was to estimate the prevalence of defined PA frequency levels among AARP Medicare Supplement insureds and determine associated characteristics.
A second objective was to document the benefits of increasing PA frequency levels on 1 the prevalence of common physical and mental chronic conditions, 2 health care utilization ie, inpatient admissions and emergency room [ER] visitsand 3 medical and prescription drug expenditures.
The final study sample included 17, survey respondents and was used to determine overall prevalence, characteristics, and health outcomes associated with PA.
The age-related study objectives included stratification of this study sample by 3 age groups: Light-to-moderate PA levels were identified from survey responses to the following question: How many days per week do you get 30 minutes or more of light-to-moderate PA? Examples include walking, gardening, golfing, among others, with possible responses of 0—7 days per week. The survey was delivered via interactive voice response telephonic outbound calls from a designated list ofrandomly selected insureds.
Three PA levels were defined from the survey responses querying weekly frequency of light-to-moderate PA: Outcomes Prevalence of common chronic conditions Nine common medical conditions used in calculating the Charlson Comorbidity Index CCI score 34 were defined from diagnoses codes in the health care claims: CCI is a measure of the risk of 1-year all-cause mortality attributable to selected comorbidities that also has been shown to be highly predictive of morbidity and health care expenditures.
The validated 2-item depression questionnaire, Patient Health Questionnaire-2 PHQ-2was used to screen for depression. Health care utilization is shown as an annual rate percentage. Health care expenditures were defined as paid claims per member per month PMPM US dollars from the same time period aggregated from Medicare, Medicare Supplement, and patient out-of-pocket paid amounts.
Covariates Covariates were included to characterize PA levels and to adjust for factors that may influence the prevalence of chronic conditions, health care utilization, and expenditures.
These covariates included measures of demographics, socioeconomic factors, health status, and other characteristics taken from health plan eligibility and administrative medical claims. It has been found, for example, that both subjective well-being and satisfaction with life correlate positively with physical well-being health [ 11 — 14 ,] as well as with behaviors aimed at improving health or physical well-being, such as physical-sporting activity [ 8 ].
The Frequency and Health Benefits of Physical Activity for Older Adults
A review of the scientific literature focusing on well-being reveals the many types of different variables that are associated with this concept: However, studies on the possible connections, which may exist between physical exercise and psychological well-being are lacking. Considerable effort has been made over recent years to fill this empirical gap, due to the importance attached to physical-sporting activity as a means of preventing various negative emotions and physical diseases.
Although sports science and physical activity studies insist that physical exercise results in higher levels of well-being [ 2021 ], the vast majority of studies have overlooked the importance of fostering quality of life understood as psychological well-being, focusing instead on exploring its links with anxiety, depression, and diverse psychopathologies [ 2021 ].
The few studies that have focused on analyzing the relationship between physical activity and the different components of psychological well-being have found that those who engage in physical activity score higher for both well-being in general and its three dimensions: However, when frequency of physical activity is taken into account, the differences observed in negative affect disappear and the same also occurs sometimes with satisfaction with life [ 22 ].
In other words, in measures of global well-being and positive affect, the results differ in accordance with the frequency of the physical activity engaged in, with more frequent exercise resulting in higher scores than more sporadic activity.
However, this is not true for measures of satisfaction with life or the degree of negative affect experienced, for which the most important thing seems to be the act of engaging in physical activity itself, regardless of the frequency of practice. Certain characteristics of this physical activity have also been analyzed, specifically the intensity and type of organization [ 23 ]. In regard to intensity, it has been found that psychological well-being is higher among those who engage in physical activity with a medium level of intensity.
On the other hand, results reveal that the type of organization within which the physical activity is carried out extracurricular club, federation, unmonitored or monitored has no impact on psychological well-being; what is really important here is the fact of engaging in some kind of physical activity, no matter its format. In the field of quality of life understood as physical health, research focuses on the analysis of health-related quality of life HRQL and is based on the subjective assessment of the impact of disease and treatment on the domains of functioning and physical well-being.
These studies have found that quality of life is a predictive variable of the course of several diseases, regardless of other prognostic factors, suggesting that a poorer quality of life could in itself aggravate the disease [ 24 ].
According to Soto et al. To date, reviews quantifying the results of exercise interventions indicate that relatively few studies report any quality of life data, and in most clinical trials the quality of life is evaluated as a secondary variable [ 26 ]. It has, however, been recommended that HRQL should play an important role as a main outcome variable [ 27 ], and of course, this variable should always be assessed and defined by the individual patient, the focus being on the person rather than on the disease, placing importance on how the patient feels, regardless of clinical results.
Coronary heart disease is one of the most widespread health problems, and is among those which could benefit most from physical activity in relation to HRQL. In this sense, regular physical exercise has been shown to be inversely associated with the risk of coronary heart disease, cardiac events and death [ 28 ]. Moreover, functional capacity may also be inversely related to all-cause and cardiovascular morbidity and mortality in coronary heart disease patients.
Moreover, according to some studies, physical exercise also has a positive impact on the HRQL of these patients, although the effect of size is generally small [ 29 ]. The combination of the magnitude of the problem of coronary heart disease, the impact that it has on the social, family and working lives of those who suffer from it, and the psychiatric factors associated with its evolution makes HRQL a key aspect to bear in mind.
Other studies have tried to clarify the relationship between subjective well-being and health-related quality of life. A covariation of both was found with those with high rates of psychological well-being reporting better health-related quality of life compared to those who reported a moderate sense of psychological well-being [ 30 ].
Other studies have found empirical evidence regarding the negative effect of chronic or long-term health problems on subjective well-being [ 37 ], suggesting that the experience of being ill alters the relationship between quality of life and subjective well-being. However, while it is important to understand the relationship between quality of life, psychological well-being and physical health, it is even more important to understand what factor or factors can improve these three aspects simultaneously.
And it seems that the answer may well be physical activity, since, as shown above, it has been found that engaging in physical activity on a regular basis may be one of the most important factors for improving quality of life, both in the case of psychological well-being and in relation to health-related well-being.
The Frequency and Health Benefits of Physical Activity for Older Adults
Nevertheless, further studies are required to test this relationship and to verify that physical activity can indeed be considered a means of improving health-related quality of life. Finally, this chapter presents two different studies carried out in accordance with the two approaches to quality of life psychological and physical. The first study was conducted with the aim of analyzing the possible relationship between physical exercise and the three components of psychological well-being, whereas the second study focused on comparing two types of exercise and their effect on health-related quality of life.
Study on physical activity and psychological well-being A total of randomly selected students aged between 12 and 23 participated in the study.
The questionnaires were administered in public and semi-private schools, high schools and universities with a medium sociocultural level in the north of Spain specifically in the Autonomous Regions of the Basque County, La Rioja and Burgos.
Among the total sample, With regard to physical activity, participants claimed they never to do any exercise, whereas the remaining said they did claimed to do so regularly, said they exercised between one and three times a week and claimed to engage in physical activity more than three times a week.
Study on physical activity and health-related quality of life The sample was drawn from among the patient population of eight Spanish hospitals. All patients under the age of 80 were eligible for the study, providing they had suffered an acute ischemic cardiopathology within the last 3 months not including the last 15 dayshad been classified as having a low-risk prognosis and presented none of the exclusion criteria.