Physical activity for the over-65s: could it be a cost-effective exercise for the NHS?

BACKGROUND There is increasing interest in the health-promoting potential of physical activity in older adults. The objective of this study was to estimate the likely costs, health benefits and consequences for the National Health Service which might result from a publicly funded programme of regular exercise made available to a population of 10,000 people over the age of 65. METHODS Risk education data from observational studies were used to calculate the possible impact of a community-based programme of activity on hospital admissions and deaths from coronary heart disease, stroke, diabetes, femoral neck fractures and mental disorders. The avoided costs of health care and net cost per life-year saved were estimated. RESULTS Providing twice-weekly exercise classes for 10,000 participants would cost approximately 854,700 pounds per year, but would prevent 76 deaths and 230 in-patient episodes, avoiding annual health care costs of approximately 601,000 pounds. Assuming the mean expectation of life after 65 to be ten years, the programme would cost about 330 pounds per life-year saved. Under a range of more extreme assumptions, the cost per life-year saved would vary from 100 pounds to 1500 pounds. CONCLUSIONS A publicly funded programme of regular moderate exercise for over-65-year-olds could achieve important health benefits at relatively low cost. The estimates provided by this analysis should now be tested in a rigorous randomized trial, and health commissioners should begin to think of purchasing exercise programmes alongside other health-promoting measures.