Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study

IntroductionUnderstanding factors that influence care service use is crucial for developing preventive strategies to maintain independence among older adults. In this study, we aimed to identify distinct trajectory groups of municipal care service use among community-dwelling older adults to determi...

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Main Authors: Astrid Ustad, Trine Holt Edwin, Kjerstin Næss Melsæter, Karen Sverdrup, Gro Gujord Tangen, Øystein Døhl, Pernille Thingstad, Beatrix Vereijken, Nina Skjæret-Maroni
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Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1539179/full
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author Astrid Ustad
Trine Holt Edwin
Kjerstin Næss Melsæter
Karen Sverdrup
Karen Sverdrup
Gro Gujord Tangen
Gro Gujord Tangen
Øystein Døhl
Øystein Døhl
Pernille Thingstad
Pernille Thingstad
Beatrix Vereijken
Nina Skjæret-Maroni
author_facet Astrid Ustad
Trine Holt Edwin
Kjerstin Næss Melsæter
Karen Sverdrup
Karen Sverdrup
Gro Gujord Tangen
Gro Gujord Tangen
Øystein Døhl
Øystein Døhl
Pernille Thingstad
Pernille Thingstad
Beatrix Vereijken
Nina Skjæret-Maroni
author_sort Astrid Ustad
collection DOAJ
description IntroductionUnderstanding factors that influence care service use is crucial for developing preventive strategies to maintain independence among older adults. In this study, we aimed to identify distinct trajectory groups of municipal care service use among community-dwelling older adults to determine whether daily physical activity is associated with future care service use.MethodsThis prospective cohort study included 981 community-dwelling older adults from the HUNT4 Trondheim 70+ study. At baseline, physical activity was assessed over seven consecutive days using two accelerometers attached to the thigh and lower back. An activity type machine learning model was used to classify the physical activity types: walking, standing, cycling, running, sitting, and lying. Municipal care service use was retrieved monthly from medical records for 3 years. Using group-based trajectory modeling, we identified distinct trajectories of care service use. Multinomial regression models adjusted for age, sex, education level, dementia, and physical performance were used to evaluate the associations between daily physical activity at baseline and care service group belonging.ResultsWe identified four distinct trajectory groups of municipal care service use, labeled steady low (72.7%), low increasing (9.0%), medium increasing (12.0%), and high increasing (6.3%). Daily time spent in total physical activity was not associated with trajectory group belonging when adjusted for age, sex, education level, dementia, and physical performance. However, more time spent walking, in bouts lasting longer than a minute, was associated with a reduced relative risk of belonging to the high increasing compared to the steady low group. Furthermore, age, physical performance, and dementia were all significantly associated with trajectory group belonging, and sex differences were observed. Compared to women, men had a reduced relative risk of belonging to the low increasing, medium increasing, or high increasing trajectory groups.ConclusionThis study identified four distinct trajectories of municipal care service use among older adults over 3 years. Total daily physical activity was not associated with trajectories of care service use, but more time spent walking in longer bouts was independently associated with lower care service use, even when adjusted for the strong predictors of physical performance, dementia diagnosis, and age.
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spelling doaj-art-c9724e48a2f0403d9d6af43117e509952025-08-20T03:01:07ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.15391791539179Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ studyAstrid Ustad0Trine Holt Edwin1Kjerstin Næss Melsæter2Karen Sverdrup3Karen Sverdrup4Gro Gujord Tangen5Gro Gujord Tangen6Øystein Døhl7Øystein Døhl8Pernille Thingstad9Pernille Thingstad10Beatrix Vereijken11Nina Skjæret-Maroni12Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Geriatric Medicine, Oslo University Hospital, Oslo, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Geriatric Medicine, Oslo University Hospital, Oslo, NorwayNorwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, NorwayDepartment of Geriatric Medicine, Oslo University Hospital, Oslo, NorwayNorwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Oslo, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Finance, Trondheim Municipality, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Health and Welfare, Trondheim Municipality, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayIntroductionUnderstanding factors that influence care service use is crucial for developing preventive strategies to maintain independence among older adults. In this study, we aimed to identify distinct trajectory groups of municipal care service use among community-dwelling older adults to determine whether daily physical activity is associated with future care service use.MethodsThis prospective cohort study included 981 community-dwelling older adults from the HUNT4 Trondheim 70+ study. At baseline, physical activity was assessed over seven consecutive days using two accelerometers attached to the thigh and lower back. An activity type machine learning model was used to classify the physical activity types: walking, standing, cycling, running, sitting, and lying. Municipal care service use was retrieved monthly from medical records for 3 years. Using group-based trajectory modeling, we identified distinct trajectories of care service use. Multinomial regression models adjusted for age, sex, education level, dementia, and physical performance were used to evaluate the associations between daily physical activity at baseline and care service group belonging.ResultsWe identified four distinct trajectory groups of municipal care service use, labeled steady low (72.7%), low increasing (9.0%), medium increasing (12.0%), and high increasing (6.3%). Daily time spent in total physical activity was not associated with trajectory group belonging when adjusted for age, sex, education level, dementia, and physical performance. However, more time spent walking, in bouts lasting longer than a minute, was associated with a reduced relative risk of belonging to the high increasing compared to the steady low group. Furthermore, age, physical performance, and dementia were all significantly associated with trajectory group belonging, and sex differences were observed. Compared to women, men had a reduced relative risk of belonging to the low increasing, medium increasing, or high increasing trajectory groups.ConclusionThis study identified four distinct trajectories of municipal care service use among older adults over 3 years. Total daily physical activity was not associated with trajectories of care service use, but more time spent walking in longer bouts was independently associated with lower care service use, even when adjusted for the strong predictors of physical performance, dementia diagnosis, and age.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1539179/fullolder adultscare serviceshealth care utilizationtrajectory modelingphysical activityphysical performance
spellingShingle Astrid Ustad
Trine Holt Edwin
Kjerstin Næss Melsæter
Karen Sverdrup
Karen Sverdrup
Gro Gujord Tangen
Gro Gujord Tangen
Øystein Døhl
Øystein Døhl
Pernille Thingstad
Pernille Thingstad
Beatrix Vereijken
Nina Skjæret-Maroni
Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
Frontiers in Public Health
older adults
care services
health care utilization
trajectory modeling
physical activity
physical performance
title Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
title_full Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
title_fullStr Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
title_full_unstemmed Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
title_short Daily physical activity and trajectories of care service use among older adults: the HUNT4 Trondheim 70+ study
title_sort daily physical activity and trajectories of care service use among older adults the hunt4 trondheim 70 study
topic older adults
care services
health care utilization
trajectory modeling
physical activity
physical performance
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1539179/full
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