Effect of physical activity on the risk of frailty: A systematic review and meta-analysis

Abstract

Objective The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies. Methods A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51–0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52–0.77, 49% (ES: 0.51, 95% CI: 0.41–0.63), and 30% (ES: 0.70, 95% CI: 0.65–0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups. Conclusions This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.

Internet use and frailty in middle-aged and older adults: Findings from developed and developing countries

“…[50] Another recent review [51] revealed that e-health and m-health technologies increase physical activities, which could improve the frailty status. [52] Therefore, internet access among middle-aged and older adults would be helpful to build a healthy aging society.…”

Integrated effects of nutrition‐related, physical, and social factors on frailty among community‐dwelling older adults: A 7‐year follow‐up from the Kashiwa cohort study

“…26 Regarding physical factors, an increasing physical activity level may promote appetite or gastric emptying in older adults, thus increasing their food intake 27 as well as reducing the risk of frailty. 28 Moreover, an intervention study has shown that a 12-week stepping-based aerobic exercise program effectively improved fatigue and frailty in older adults with multimorbidity. 29 In addition, physical activity has been shown to prevent the deterioration of physical functions such as gait speed, grip strength, and even sarcopenia.…”

“…However, poor oral status has been reported to strongly predict new‐onset frailty and mortality in community‐dwelling older adults 26 . Regarding physical factors, an increasing physical activity level may promote appetite or gastric emptying in older adults, thus increasing their food intake 27 as well as reducing the risk of frailty 28 . Moreover, an intervention study has shown that a 12‐week stepping‐based aerobic exercise program effectively improved fatigue and frailty in older adults with multimorbidity 29 .…”

Therapie der physischen Frailty

“…Inhaltlich sollen nach dieser Leitidee die körperliche Fitness und das Aktivitätsverhalten der Personen regelmäßig bewertet und mittels personalisierter Interventionsmethoden in der Therapie und Nachsorge gefördert werden. Auch in Bezug auf die Entwicklung der Frailty erweist sich regelmäßige körperliche Aktivität als präventiv (s. Beitrag "Frailty: Prävention", S. 155) [4]. Hierbei beschreibt körperliche Aktivität jede von der Skelettmuskulatur ausgeübte Bewegung, die den Energieverbrauch über den Grundumsatz erhöht.…”