Q&A: Fitness program reduces hospitalizations in older adults
Recent data showed that older adults who participated in the SilverSneakers exercise program had significantly fewer hospitalizations and emergency room visits than nonparticipants.
The analysis by Tivity Health also showed that the program was associated with higher rates of medication adherence and preventive screenings.
For the analysis, researchers matched 8,555 participants in the SilverSneakers program (mean age, 67.5 years; 64% women; 79% white) with 42,775 controls.
SilverSneakers participants had higher rates of hypertension (41.4% vs. 41.1%), hyperlipidemia (39% vs. 36.5%), rheumatoid arthritis or osteoarthritis (20% vs. 16%), cataracts (16.1% vs. 13.5%), acquired hypothyroidism (12.3% vs. 10.4%) and depression (11.6% vs. 9.2%), but lower rates of diabetes (14.6% vs. 16.4%).
Compared with the matched controls, SilverSneakers participants had 42% fewer hospitalizations (9.96 vs. 17.26; P < .0001) and 18% fewer emergency room visits (34.18 vs. 41.75; P < .0001). SilverSneakers participants also had lower total health care costs ($4,463 vs. $5,303; P < .0001) and total medical costs ($2,795 vs. $3,763; P < .0001).
The data further showed that Silver Sneakers participants had greater rates of adherence to medication for hypertension (90% vs. 85%; P < .001) and cholesterol (86% vs. 82%; P < .001), as well as higher rates of preventive screenings, including colonoscopy screening (21.1% vs. 16.4%; P < .05), depression screening and follow-up plans (92.8% vs. 85.6%; P < .05), prostate cancer screening (25.3% vs. 20.9%; P < .05), cholesterol screening (53.1% vs. 49.7%; P < .05) and breast cancer screening (77.7% vs. 66.5%; P < .05).
Healio Primary Care spoke with Richard Ashworth, PharmD, the CEO and a board member of Tivity Health, to learn more about the SilverSneakers program, the benefits of exercise programs among older adults and more.
Healio Primary Care: Can you discuss the SilverSneakers program?
Ashworth: SilverSneakers started in 1992 to provide a fitness program designed specifically for older adults, with accessible fitness options for every senior regardless of health state. It has grown to become the leading community fitness program for older adults, with nearly 18 million eligible members in all fifty states.
SilverSneakers empowers older adults and drives meaningful behavior change through convenient access to our nationwide fitness network of more than 15,000 locations, expert-led programming and digital engagement tools.
We offer SilverSneakers through more than 70 Medicare Advantage, Medicare Supplement and group retiree plans. Our members love the program because it helps them to stay active and social as they age, and our health plans appreciate the measurable improvement in overall health and reduction in health care costs for participants.
Healio Primary Care: In what sort of exercise classes or other programs did participants partake? Were there group classes?
Ashworth: For the Medicare claims study, we defined participants as those who were engaging in the program in some way — virtually, in our classes or by visiting a gym. SilverSneakers members have access to fitness locations nationwide as well as a wide variety of in-person and virtual fitness classes and workshops to support a healthy lifestyle.
One of the benefits of our program is that there is something for everyone and each member can find the program that is right for them. Our class types include a wide variety of every fitness level, including yoga, cardio, strength training and chair classes. We have members who are distance runners and senior Olympic champions, and we have members who have never before visited a gym. We can support each and every one of them in maintaining and improving their health.
Healio Primary Care: How did the COVID-19 pandemic affect participation?
Ashworth: Early in the pandemic, many of our partner fitness locations closed and most seniors followed public health guidance to shelter in place. So, our in-person visits declined. However, we quickly pivoted to offer virtual classes, first through Facebook Live and then through Zoom.
Today, SilverSneakers members have access to more than 13,000 live with instructor classes each month as well as about 200 classes in our SilverSneakers On-Demand library. Many participants in our virtual program — about 35% — are engaging with SilverSneakers for the first time, giving members who may not be comfortable going to the gym an at-home option. And we are seeing members return to their previous fitness routines as they are getting vaccinated.
Healio Primary Care: What do the findings suggest about the benefit of exercise programs and other wellness activities for older people?
Ashworth: This study validates that SilverSneakers improves health outcomes and lowers health care costs for participants when compared with nonmembers of equivalent health. The participants we looked at in this study were not an inherently healthier population; they had similar or higher proportions of top comorbid conditions compared to the matched cohort. Their total health care costs were reduced by 16% overall and the medical component of costs was reduced by 26%, driven primarily by reductions in inpatient costs. These participants also engaged in healthy behaviors beyond just exercise, including keeping up with routine medical appointments and screenings and staying current with prescribed medications.
Healio Primary Care: What is your take-home message for primary care providers?
Ashworth: We know from other Tivity Health research that primary care providers are one of the most trusted sources of health information for older adults. These providers should be supporting their patients in all aspects of health, encouraging them to engage in activities like SilverSneakers that support a healthy lifestyle. Programs like SilverSneakers can also be an important component to support value-based care because we focus on keeping members healthy, active and mobile. Many seniors don’t even know that they are eligible for this benefit at no additional cost to them. They can check to see if they’re eligible at www.silversneakers.com.
Tivity SilverSneakers Impact Analysis Pre-/Post- and Matched Medicare Advantage Control Group Analyses. Accessed May 19, 2021. Available at: http://www.tivityhealth.com/wp-content/uploads/2021/04/Avalere-SilverSneakers-Cost-Study-Full-Deck_Avalere-Updated-4-26-21.pdf.