Health Care Providers' Advice on Lifestyle Modification for Older Adults

Objectives: To describe the pattern of healthcare providers’ advice on lifestyle modification to older adults, and identify correlates of receiving such advice. Design: cross-sectional survey. Setting and Participants: Data from the National Health and Nutrition Examination Survey study from 2007-2016 on adults ≥65 years (n=3,758) were analysed. Methods: We estimated the weighted prevalence and correlates of receiving advice on the following lifestyle modifications: 1) increase physical activity, 2) reduce fat/calories, 3) control/lose weight and 4) a combination of control/lose weight and physical activity. Data were analysed according to level of comorbidity (number of chronic conditions including high blood pressure, high blood cholesterol, type 2 diabetes mellitus, coronary heart disease, and arthritis) and body mass index (BMI). Results: Physical activity was the most widely prescribed lifestyle modification, reported by 15.7% of older adults free of chronic conditions and 28.9%, 35.4% and 52.6% of older adults with 1, 2 and ≥3 comorbidities. Advice on reducing fat/calories was reported by 9.2%, 18.5%, 26.3% and 40.9% of older adults with 0, 1, 2 and ≥3 comorbidities, respectively, and advice on weight loss/control was reported by 6.5%, 19.1%, 20.8% and 37.5% respectively. The combination of advice on weight loss/control and physical activity was least commonly reported: 5.1%, 13.5%, 16.6% and 32.0% respectively. Overall, lifestyle modifications were more frequently advised to older adults who were overweight, obese, or Hispanic. Conclusions and implications: In the US, lifestyle modifications are not routinely recommended to older adults, particularly those free of chronic conditions, presenting a missed opportunity for chronic disease prevention and management. Among those advised to lose or manage weight, concurrent advice to increase physical activity is not consistently provided.