Impact of walking on life expectancy and lifetime medical expenditure: the Ohsaki Cohort Study.
Impact of walking on life expectancy and lifetime medical expenditure: the Ohsaki Cohort Study.
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DOI：
10.1136/bmjopen-2011-000240
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发表时间：
2011-01-01
期刊：
影响因子：
2.9
通讯作者：
Tsuji I
中科院分区：
文献类型：
--
作者：
Nagai M;Kuriyama S;Kakizaki M;Ohmori-Matsuda K;Sone T;Hozawa A;Kawado M;Hashimoto S;Tsuji I
步行时间越长的人对医疗保健的需求就越低。然而，鉴于他们的预期寿命较长，尚不清楚他们一生的医疗支出是增加了还是减少了。本研究调查了步行时间、预期寿命和终生医疗费用之间的关系。作者对27名 738名参与者进行了跟踪调查，年龄在40-79 岁之间，并前瞻性地收集了他们13年期间的医疗支出和生存数据。受试者分为每天步行1次和≥1次 h两组。作者构建了寿命表，分别用泊松回归模型和线性回归模型估计多调整死亡率和医疗费用，估计了40 岁的期望寿命和终生医疗费用。每天步行1 h的参与者的预期寿命从40 开始比每天步行1 h的参与者更长。那些每天步行1 h的人的多调整预期寿命为44.81 年，男性显著降低1.38 年(p=0.0073)，女性57.78 年显著降低(p=0.2351)，女性无显著降低1.16 年(p=0.2351)。除了较长的预期寿命外，每天步行1≥h的参与者从40 年龄开始需要的终生医疗费用比每天步行1 h的参与者低。那些每天步行1 h的人的多调整终生医疗费用为GB 99 423.6，男性显著降低7.6%(p=0.0048)，GB 128 161.2，女性无显著降低2.7%(p=0.2559)。更健康的生活方式带来的寿命延长并不一定意味着一生中医疗支出的增加。鼓励人们步行可能会延长预期寿命，减少终生医疗支出，尤其是对男性来说。当步行的时间增加时，每月的医疗费用就会减少。走路与降低死亡风险有关。鉴于步行更长的人的预期寿命增加，尚不清楚终生医疗支出是因此增加还是减少。与每天步行1 h的男性和女性相比，从40≥年龄开始，每天步行1 h的男性和女性的终生医疗费用分别减少了7.6%和2.7%。由于健康的生活方式而增加的寿命并不一定转化为终生医疗费用的增加。这是第一次研究步行、预期寿命和终生医疗费用之间的关系。我们使用一个简单的问卷来评估步行，在问卷中，我们要求参与者只报告步行所用的时间，而不询问步行速度、步行距离或锻炼步行与其他原因之间的任何区别。
People who spend a longer time walking have lower demands for medical care. However, in view of their longer life expectancy, it is unclear whether their lifetime medical expenditure increases or decreases. The present study examined the association between time spent walking, life expectancy and lifetime medical expenditure. The authors followed up 27 738 participants aged 40–79 years and prospectively collected data on their medical expenditure and survival covering a 13-year-period. Participants were classified into those walking <1 and ≥1 h per day. The authors constructed life tables and estimated the life expectancy and lifetime medical expenditure from 40 years of age using estimate of multiadjusted mortality and medical expenditure using a Poisson regression model and linear regression model, respectively. Participants who walked ≥1 h per day have a longer life expectancy from 40 years of age than participants who walked <1 h per day. The multiadjusted life expectancy for those who walked ≥1 h per day was 44.81 years, significantly lower by 1.38 years in men (p=0.0073) in men and 57.78 years in women, non-significantly lower by 1.16 years in women (p=0.2351). In addition to their longer life expectancy, participants who walked ≥1 h per day required a lower lifetime medical expenditure from 40 years of age than participants who walked <1 h per day. The multiadjusted lifetime medical expenditure for those who walked ≥1 h per day was £99 423.6, significantly lower by 7.6% in men (p=0.0048) and £128 161.2, non-significantly lower by 2.7% in women (p=0.2559). Increased longevity resulting from a healthier lifestyle does not necessarily translate into an increased amount of medical expenditure throughout life. Encouraging people to walk may extend life expectancy and decrease lifetime medical expenditure, especially for men. Medical expenditure per month was reduced when the amount of time spent walking was increased. Walking is associated with a decreased risk of mortality. In view of the increased life expectancy of those who walk longer, it is unclear whether lifetime medical expenditure increases or decreases as a result. Lifetime medical expenditure from the age of 40 years for men and women who walked ≥1 h per day was reduced by 7.6% and 2.7%, respectively, in comparison with those who walked <1 h per day. Years of life added as a result of a healthy lifestyle did not necessarily translate into an increased amount of lifetime medical expenditure. This is the first study to investigate the association between walking, life expectancy and lifetime medical expenditure. We assessed walking using a simple questionnaire, in which we asked the participants to report only the time spent walking, and did not ask about walking pace, distance walked or any distinction between walking for exercise and other reasons.
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DOI：
10.1136/bmj.b4460
发表时间：
2009-11-10
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Dumurgier J;Elbaz A;Ducimetière P;Tavernier B;Alpérovitch A;Tzourio C
通讯作者：
Tzourio C
影响因子：
4.4
作者：
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通讯作者：
Ueshima, Hirotsugu
影响因子：
12.7
作者：
HATZIANDREU, EI;KOPLAN, JP;WARNER, KE
通讯作者：
WARNER, KE
影响因子：
4.9
作者：
Kuriyama, S;Tsuji, I;Hisamichi, S
通讯作者：
Hisamichi, S
影响因子：
37.8
作者：
Hakim, AA;Curb, JD;Abbott, RD
通讯作者：
Abbott, RD