Association between Lifestyle Behaviors and Medical Expenses in Older Adults with Mental Illness

Research Objectives: To examine the association between lifestyle habits and medical expenses and suggest the importance of lifestyle behaviors.

Design: Cross-sectional study.

Setting: Medical claims data of the Korea National Health Insurance Services.

Participants: We extracted 32,853 older adults’ demographic and clinical characteristics from the older adults’ cohort database. The inclusion criteria are having medical records of medical services for a mental illness in 2014 or 2015.

Interventions: Not applicable.

Main Outcome Measures: The independent variables were lifestyle habits, including the number of drinking a week, current smoking status, and physical activity, and the dependent variable was medical expenses($). The covariates were sex, age, residential area, socioeconomic status, absence of disability rating, and Charlson comorbidity index.

Results: The participants consisted of 12,617 (38.40%) males and 20,236 (61.60%) females, with an average age of 76.89±3.97 years. The study findings indicated a significant association between lifestyle and medical expenses in older adults with mental illness. The non-smokers had significantly lower medical expenses than smokers (estimate = -174, 95% confidence interval [CI] = -338 to –9, p = .038). The number of days of walking per week was negatively associated with medical expenses (estimate = -47, 95% CI = -60 to -32, p<.0001). The results showed that more walking exercise and less smoking have led to lower medical expenses.

Conclusions: This study suggests the importance of a healthy lifestyle for older adults with mental illness. In future research, it is necessary to analyze the causal relationship between reducing medical expenses and improving the quality of life of the elderly with mental illness through healthy lifestyle education.

Author(s) Disclosures: All authors have no disclosure.