The modelled impact of increases in physical activity: the effect of both increased survival and reduced incidence of disease
AuthorMytton, OT; Tainio, M; Ogilvie, D; Panter, J; Cobiac, L; Woodcock, J
Source TitleEuropean Journal of Epidemiology
University of Melbourne Author/sCOBIAC, LINDA
AffiliationMelbourne School of Population and Global Health
Document TypeJournal Article
CitationsMytton, O. T., Tainio, M., Ogilvie, D., Panter, J., Cobiac, L. & Woodcock, J. (2017). The modelled impact of increases in physical activity: the effect of both increased survival and reduced incidence of disease. EUROPEAN JOURNAL OF EPIDEMIOLOGY, 32 (3), pp.235-250. https://doi.org/10.1007/s10654-017-0235-1.
Access StatusOpen Access
NHMRC Grant codeNHMRC/1036771
Physical activity can affect 'need' for healthcare both by reducing the incidence rate of some diseases and by increasing longevity (increasing the time lived at older ages when disease incidence is higher). However, it is common to consider only the first effect, which may overestimate any reduction in need for healthcare. We developed a hybrid micro-simulation lifetable model, which made allowance for both changes in longevity and risk of disease incidence, to estimate the effects of increases in physical activity (all adults meeting guidelines) on measures of healthcare need for diseases for which physical activity is protective. These were compared with estimates made using comparative risk assessment (CRA) methods, which assumed that longevity was fixed. Using the lifetable model, life expectancy increased by 95 days (95% uncertainty intervals: 68-126 days). Estimates of the healthcare need tended to decrease, but the magnitude of the decreases were noticeably smaller than those estimated using CRA methods (e.g. dementia: change in person-years, -0.6%, 95% uncertainty interval -3.7% to +1.6%; change in incident cases, -0.4%, -3.6% to +1.9%; change in person-years (CRA methods), -4.0%, -7.4% to -1.6%). The pattern of results persisted under different scenarios and sensitivity analyses. For most diseases for which physical activity is protective, increases in physical activity are associated with decreases in indices of healthcare need. However, disease onset may be delayed or time lived with disease may increase, such that the decreases in need may be relatively small and less than is sometimes expected.
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