Do you want to remain independent and delay entering residential aged care for as long as possible?

Perhaps the will is there but, like most things as we get older, the body is resistant.

A study by Australian researchers could prove handy in working out how best to stay out of a nursing home.

It’s pretty simple. Avoid:

• Physical inactivity.

• Smoking.

• Poor diet.

• Sleep disorders.

In a study involving more than 125,000 Australians, those over 60 with the unhealthiest lifestyles were significantly more likely to require admission to aged care than their peers with the healthiest lifestyles.

The Sydney University researchers found that the lifestyle of people aged between 60 and 64 is linked to their risk of admission to aged care.

“We know that factors like poor sleep and inactivity increase people’s risk of developing diseases like dementia and diabetes,” Dr Alice Gibson of the University of Sydney’s Charles Perkins Centre and Menzies Centre for Health Policy and Economics said.

“But this is the first study to look at the independent and combined impact these established and emerging lifestyle behaviours have on a person’s risk of admission into aged care.”

The good news is we can be proactive in altering the risk of being admitted to an aged care facility. How? By modifying our lifestyle.

“This is incredibly timely with the latest Intergenerational Report suggesting the number of people aged 65 and over in Australia will more than double over the next four decades, with an unprecedented demand on the aged care sector,” Dr Gibson said. 

The three-year study required participants to complete a lifestyle questionnaire on five key risk factors: smoking, physical activity levels, sitting time, sleep patterns, and diet. 

Based on the responses, participants were categorised into low, medium, or high-risk lifestyle groups. Around 1 in 4 (24%) were allocated to the low-risk group, nearly two thirds (62%) to the medium risk group, and 14% to the high-risk group.

Those in the low-risk group needed to score in the lower risk for all but one lifestyle factor and, conversely, those in the high-risk group could not score at low risk for more than two of the lifestyle factors. Low risk was defined as adhering to national preventative health guidelines.

The researchers then linked this data with participants’ medical records via the Medicare Benefits Schedule and hospital data, allowing them to monitor for aged care admissions over 10 years.

Among the 127,108 participants with an average follow-up of 10 years, 23,094 participants (18%) were admitted to a nursing home.

Compared with over-60s in the low-risk lifestyle group, the risk of aged care admission was 43% higher for those in the high-risk group, and 12% higher for those in the medium risk group.

As the lifestyle score increased, the risk of admission to a nursing home decreased. However, this trend differed by age and physical impairment.

For instance, lifestyle factors were especially influential among people aged 60 to 64. Those in this age bracket with the unhealthiest lifestyle were more than twice as likely to be admitted to aged care than those with the healthiest lifestyle.

The risk of admission was highest (55% higher) for current smokers, compared with those who had never smoked.

Given the study’s limitations, the researchers concluded that in the Australian population, “lifestyle factors are strongly associated with the risk of long-term nursing home admission in men and women older than 60 years”.

This evidence is an important contribution to aged care policy and is a personal motivator for lifestyle changes among younger at-risk individuals who do not want to lose their future independence and want to remain in their homes for as long as possible.

On a public health level, to reduce the burden on our aged care system, the study suggests we should be looking at strategies to encourage older people to:

• Stop smoking.

• Reduce sitting time.
  

• Increase physical activity.

• Get a good night’s sleep.

Related reading: Sydney University, ABC, Health Department