Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis

Navarrete-Villanueva, David; Gómez-Cabello, Alba; Marín-Puyalto, Jorge; Moreno, Luís A.; Vicente-Rodríguez, Germán; Casajús, José Antonio

doi:10.1007/s40279-020-01361-1

Cited by 64 publications

(45 citation statements)

References 58 publications

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“…This result is in line with 37 where a key observation was that maximum gait speed declines more steeply than comfortable gait speed with increasing age. Findings were similar when the analysis was restricted to participants aged 65 years and over, indicating that those metrics can be used in all age groups and to monitor disability in aging, as suggested recently 41 .…”

Section: Discussionsupporting

confidence: 69%

Real-world gait speed estimation, frailty and handgrip strength: a cohort-based study

Soltani

Abolhassani

Marques‐Vidal

et al. 2021

Sci Rep

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Gait speed is a reliable outcome measure across multiple diagnoses, recognized as the 6th vital sign. The focus of the present study was on assessment of gait speed in long-term real-life settings with the aim to: (1) demonstrate feasibility in large cohort studies, using data recorded with a wrist-worn accelerometer device; (2) investigate whether the walking speed assessed in the real-world is consistent with expected trends, and associated with clinical scores such as frailty/handgrip strength. This cross-sectional study included n = 2809 participants (1508 women, 1301 men, [45–75] years old), monitored with a wrist-worn device for 13 consecutive days. Validated algorithms were used to detect the gait bouts and estimate speed. A set of metrics were derived from the statistical distribution of speed of gait bouts categorized by duration (short, medium, long). The estimated usual gait speed (1–1.6 m/s) appears consistent with normative values and expected trends with age, gender, BMI and physical activity levels. Speed metrics significantly improved detection of frailty: AUC increase from 0.763 (no speed metrics) to 0.798, 0.800 and 0.793 for the 95th percentile of individual’s gait speed for bout durations < 30, 30–120 and > 120 s, respectively (all p < 0.001). Similarly, speed metrics also improved the prediction of handgrip strength: AUC increase from 0.669 (no speed metrics) to 0.696, 0.696 and 0.691 for the 95th percentile of individual’s gait speed for bout durations < 30, 30–120 and > 120 s, respectively (all p < 0.001). Forward stepwise regression showed that the 95th percentile speed of gait bouts with medium duration (30–120 s) to be the best predictor for both conditions. The study provides evidence that real-world gait speed can be estimated using a wrist-worn wearable system, and can be used as reliable indicator of age-related functional decline.

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Section: Discussionsupporting

confidence: 69%

Real-world gait speed estimation, frailty and handgrip strength: a cohort-based study

Soltani

Abolhassani

Marques‐Vidal

et al. 2021

Sci Rep

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“…These overall walking speeds were faster than those reported in a previous study that used the same definition of frailty and included female participants only, but shows the same trend of slower speed in frail/prefrail participants compared with that in non-frail participants (non-frail: 0.95 m/s, frail/prefrail: 0.62 m/s) 49 . In addition, several previous studies that included both males and women reported a similar trend (non-frail: 1.03–1.4 m/s, prefrail; 0.92–1.4 m/s, frail: 0.64–1.30 m/s, 17 , 19 , 28 , 50 – 54 . Significant correlations with walking speed were found in the principal component scores of vectors 2, 3, 6, 15 and 17 (Table 4 ).…”

Section: Discussionsupporting

confidence: 63%

“…On the basis of these results, we hypothesize that these decreases in joint angle during walking could lead to a decrease in the stride length regardless of frailty status, leading to slower walking speed. Slow walking speed has also been adopted as one of the criteria for the definition of frailty by Fried et al 6 , and has been reported to provide a good reflection of frailty status 6 , 19 – 22 . It is therefore not surprising that frail older women exhibited a slower walking speed than non-frail older women in the current study.…”

Section: Discussionmentioning

confidence: 99%

Kinematic characteristics during gait in frail older women identified by principal component analysis

Tsuchida

Kobayashi

Inoue

et al. 2022

Sci Rep

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Frailty is associated with gait variability in several quantitative parameters, including high stride time variability. However, the associations between joint kinematics during walking and increased gait variability with frailty remain unclear. In the current study, principal component analysis was used to identify the key joint kinematics characteristics of gait related to frailty. We analyzed whole kinematic waveforms during the entire gait cycle obtained from the pelvis and lower limb joint angle in 30 older women (frail/prefrail: 15 participants; non-frail: 15 participants). Principal component analysis was conducted using a 60 × 1224 input matrix constructed from participants’ time-normalized pelvic and lower-limb-joint angles along three axes (each leg of 30 participants, 51 time points, four angles, three axes, and two variables). Statistical analyses revealed that only principal component vectors 6 and 9 were related to frailty. Recombining the joint kinematics corresponding to these principal component vectors revealed that frail older women tended to exhibit greater variability of knee- and ankle-joint angles in the sagittal plane while walking compared with non-frail older women. We concluded that greater variability of knee- and ankle-joint angles in the sagittal plane are joint kinematic characteristics of gait related to frailty.

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“…Severe frailty typically occurs more often in women 25 , is observed in 12-24% of older adults and is age related 26 . Increasingly, frailty is seen as modifiable, even potentially preventable, thereby making it a target of treatment [27][28][29][30][31] . Trials of nutrition and physical exercise face challenges in relation to blinding, types of controls and measurement of dosing that can be more challenging than pharmaceutical studies, especially for well-tolerated compounds 27 .…”

mentioning

confidence: 99%

The degree of frailty as a translational measure of health in aging

2021

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Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis

Cited by 64 publications

References 58 publications

Real-world gait speed estimation, frailty and handgrip strength: a cohort-based study

Real-world gait speed estimation, frailty and handgrip strength: a cohort-based study

Kinematic characteristics during gait in frail older women identified by principal component analysis

The degree of frailty as a translational measure of health in aging

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