Diet quality and body mass index are associated with healthcare resource use in rural older adults

Healthcare resource consumption is a growing concern. The aim of this study was to examine the associations between diet quality and body mass index (BMI) with healthcare resource use (HRU) in a cohort of advanced age. 5,993 Geisinger Rural Aging Study (GRAS), participants were mailed demographic and dietary questionnaires in 2009. Of those eligible 2,995 (50%; 1,267 male, 1,728 female; mean age 81.4 ± 4.4 years) provided completed surveys. Multivariate negative binomial models were used to estimate relative risk (RR) and 95% confidence intervals (95% CI) of HRU outcomes with diet quality as assessed by the dietary screening tool (DST) score and BMI determined from self-reported height and weight. Poor diet quality was associated with a 20% increased risk for ER visits. Fruit and vegetable (F+V) consumption was grouped into quintiles of intake with the highest quintile serving as the reference group in analyses. The three lowest F+V quintiles were associated with increased risk for ER visits (23-31%); the lowest quintile increased risk for inpatient visits (27%). Obesity increased risk of outpatient visits; however, individuals with class I obesity were less likely than normal weight individuals to have ER visits (RR 0.84; 95% CI 0.70, 0.99). Diets of greater quality, particularly with greater F+V intake, are associated with favorable effects on HRU outcomes among older adults. Overweight and obesity are associated with increased outpatient HRU and among obese persons, with decreased ER visits. These findings suggest that BMI and diet quality beyond age 74 continue to effect HRU measures.