Lifestyle risk factors predict healthcare costs in an aging cohort

Background: While the U.S. elderly population uses a disproportionate amount of healthcare resources, there is limited knowledge froth prospective studies regarding the impact of lifestyle-related factors on costs in this group. The association was examined between smoking, drinking, exercise, body mass index (BMI), and changes in these risk factors, and healthcare costs after 4 years among 68- to 95-year-olds. Methods: A total of 1323 participants completed annual surveys providing information on lifestyle factors (1986-1994) and health utilization (1994-1998). Healthcare costs in nine categories were ascertained from validated utilization. The relationships between risk factors and costs were examined in 2004 using linear regression models. Results: Fewer cigarette pack-years and lower BMI were the most significant predictors of lower total costs in 1998 (p < 0.001), controlling for baseline sociodemographic factors, costs, and conditions. Associations with smoking were strongest for hospitalizations, diagnostic tests, and physician and nursing-home visits. Those who reduced smoking by one pack per day experienced cost savings of $1160 (p < 0.05). The costs for normal weight compared to minimally obese seniors were approximately $1548 lower, with diagnostic testing, physician visits, and medications accounting for much of this difference. Daily walking, measured at baseline, also predicted lower costs for hospitalizations and diagnostic testing. Conclusions: Seniors who were leaner, smoked fewer cigarettes over a lifetime, reduced their smoking, or walked farther had significant subsequent cost savings compared to those with less-healthy lifestyle-related habits.