Associations Between Physical Activity in Adulthood and Utilisation of Municipal Home and Long-Term Healthcare Services in Older Age: the HUNT Study

Physical activity is a key component in public health frameworks to maintain functional ability through ageing. In Norway, healthcare services such as home health nursing and long-term institutional stays for older adults account for a significant amount of healthcare expenditures, but little is known about the association between physical activity levels through adulthood and utilisation of these services later in life. To this end, we wanted to explore an association between physical activity and the use of these specific healthcare services. We used data from three waves of the Trøndelag Health Study, that surveyed physical activity levels through questions about physical activity frequency, duration and intensity (HUNT1, 3 and 4). These questions allowed the calculation of minutes per week of moderate intensity physical activity, in addition to assessment of weekly physical activity frequencies (low-high). We included all who were either ≥ 65 years in HUNT3 or took part in all three surveys. Time-series of home health nursing and long-term institutional stays was collected from the combined Individual-based Statistics for Nursing and Care Services (IPLOS) and the Norwegian Registry for Primary Health Care (NRPHC) between 2007 and 2022. Multiple Cox proportional hazard models were built to assess the association between time to healthcare utilisation and physical activity levels. Of the 15,737 participants who took part in HUNT1 and HUNT3, 9318 also participated in HUNT4. Moderate-intensity physical activity could be calculated for 8882 participants aged ≥ 65 years in HUNT3 (53