The association between medication use and lifestyle factors in independently living older people: impact of Mediterranean diet and physical activity

Roeke, Lieke, Kennedy, Greg, Meyer, Denny, Kingsley, Michael, Itsiopoulos, Catherine, Segal, Leonie, Minihane, Anne Marie, Murphy, Karen J., Nguyen, Tuan Anh, Reddan, Jeffery M., Verster, Joris C. and Pipingas, Andrew (2025) The association between medication use and lifestyle factors in independently living older people: impact of Mediterranean diet and physical activity. Journal of Aging Research and Lifestyle, 14. pp. 1-7. ISSN 2534-773X

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Abstract

Objectives: Adherence to the Mediterranean diet (MedDiet) and engagement in physical activity (PA) are associated with a lower risk of chronic disease, yet their relationship with medication use in older adults is less clear. This study examined cross-sectional associations between MedDiet adherence, PA levels, and medication use, including polypharmacy, in independently living older Australians.  Design: A cross-sectional observational study  Setting and participants: Baseline data were drawn from the MedWalk trial, including 161 participants (119 females, 42 males; aged 60–90 years) residing in independent living facilities in Adelaide and Melbourne, and the wider Melbourne community.  Measurements: Adherence to the MedDiet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). PA was objectively measured via accelerometry and categorized as low (<150 min/week), moderate (150–<300 min/week), or high (≥300 min/week) of moderate-to-vigorous PA. Medication use was self-reported and coded using Anatomical Therapeutic Chemical (ATC) classifications. Polypharmacy was defined as use of ≥5 medications. Logistic and negative binomial regression analyses were adjusted for age, sex, education, and BMI.  Results: Moderate and high PA were associated with significantly lower odds of polypharmacy compared with low PA (AOR=0.37, p = 0.047; AOR=0.08, p = 0.022, respectively). High PA was also associated with a reduced total number of medications (exp(B)=0.44, p = 0.018) and fewer cardiovascular medications (AOR=0.29, p = 0.042). Each additional point in MedDiet adherence was associated with reduced use of alimentary tract and metabolism medications (AOR=0.78, p = 0.016), though no association was found with total medication use or polypharmacy.  Conclusion: In this cross-sectional study, higher PA was consistently associated with reduced polypharmacy and fewer medications, while greater MedDiet adherence was linked to reduced use of metabolic medications. Lifestyle practices may influence medication use patterns in later life. Larger longitudinal studies are needed to clarify causality and inform strategies to reduce polypharmacy through promotion of healthy lifestyle behaviors.

Item Type:	Article
Additional Information:	Acknowledgments We would like to thank the following organizations, their retirement villages, staff, and residents for access to facilities, advice, and assistance with the trial: In South Australia – ECH (Cumberland Park Community Group and Rotary), Karidis (Acacia Park), Lendlease (Vermont), LifeCare (Marion Rose), Retire Australia (Glengowrie, Tea Tree Gardens and Torrens Grove), RSL Care (Sturt) and Southern Cross (Riverpoint and The Pines). In Victoria – Abound Communities (Rushall Park and Leith Park), Australian Unity (Campbell Place and Peninsula Grange) and Villa Maria Catholic Homes (St Joseph Mews and Athelstan). We acknowledge the contributions of the MedWalk Collaborative Team: Bethany Bartel, Mahima Bedi, Mee Chee Chong, Nicole Echeverria, Gabriella Inguanti, Ashlee Harvey, Kasia Main, Laura Martin, Janis Onuzans, Melissa Rubin, Mahima Shah, Tania Thodis, Nerylee Watson. We would like to acknowledge MedWalk Associate Investigators for their contributions to develop the grant application and to implement the experimental protocol including assistance with recruitment and contributions on the MedWalk Advisory Board: Janet Hiller (Chair), Victoria Cornell, Megan Corlis, Colleen Doyle, Sarah Gray. We would also like to acknowledge the contributions of members on the Data Safety Monitoring Board: Naomi Perry (Chair), Won Sun (Sharon) Chen, Matthew Cook, Edward Ogden. The authors also acknowledge the assistance of Dr. Courtney Sullivan in establishing the accelerometer analysis protocol.
Uncontrolled Keywords:	lifestyle factors,medication use,mediterranean diet,older adults,physical activity,geriatrics and gerontology,health policy,internal medicine,physiology (medical),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2717
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:	https://www.scopus.com/pages/publication...
Depositing User:	LivePure Connector
Date Deposited:	19 May 2026 13:36
Last Modified:	19 May 2026 13:36
URI:	https://ueaeprints.uea.ac.uk/id/eprint/103103
DOI:	10.1016/j.jarlif.2025.100041

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