Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review

Tolley, Alec P.L.; Ramsey, Keenan A.; Rojer, Anna G M; Reijnierse, Esmee M.; Maier, Andrea B.

doi:10.1016/j.jclinepi.2021.04.009

Cited by 48 publications

(44 citation statements)

References 68 publications

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“…Previous studies have shown that having an unhealthy lifestyle is associated with frailty [ 16 – 18 ]. Studies focused on specific lifestyle factors as smoking [ 20 ], excessive alcohol use [ 24 ], poor dietary habits [ 26 ], and low physical activity [ 29 ], provided evidence that these individual factors had an effect on frailty. However, frailty was predominantly defined as a biological concept, consisting of physical limitations that older people may have, mostly represented by the phenotype of frailty [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…The systematic review carried out by Tolley et al aimed to synthesize the available evidence with regard to the associations of objectively measured habitual physical activity and frailty in community-dwelling older people. This review, based on 23 articles totaling 7,696 participants, concludes that objective measures of physical activity are associated with frailty, regardless the operational definition of frailty [ 29 ]. Based on four studies, a meta-analysis also showed that physical activity probably prevents frailty [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

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Associations between lifestyle factors and multidimensional frailty: a cross-sectional study among community-dwelling older people

2022

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Background Multidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. Methods This cross-sectional study was conducted in two samples comprising in total 45,336 Dutch community-dwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Results Higher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small. Conclusions The four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so community-dwelling older people have the possibility to aging in place accompanied by a good quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between lifestyle factors and multidimensional frailty: a cross-sectional study among community-dwelling older people

2022

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“…Furthermore, while age-specific incidence rates vary, the highest rates observed are in the 85 to 89 age group, for both males and females [ 1 ]. Advanced age is associated with recognised prognostic factors including co-morbidity [ 2 ], sarcopenia [ 3 ] and frailty [ 4 ]. Therefore, decisions on whether to embark on potentially curative treatment are often complex in older adults with CRC.…”

Section: Introductionmentioning

confidence: 99%

The prevalence and prognostic value of frailty screening measures in patients undergoing surgery for colorectal cancer: observations from a systematic review

et al. 2022

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Introduction Frailty is a complex multifactorial syndrome characterised by a significant increase in vulnerability and worsened health outcomes. Despite a range of proposed frailty screening measures, the prevalence and prognostic value of frailty in patients undergoing surgery for colorectal cancer is not clear. Aim The aim of this present review was to examine the use of commonly employed frailty screening measures in patients undergoing surgery for colorectal cancer. Methods A systematic search of PubMed and Medline was carried out to identify studies reporting the use of frailty screening tools or measures in patients undergoing surgery for colorectal cancer. The screening measure used and prevalence of frailty within the population were recorded. Outcomes of interest were the incidence of post-operative complications, 30-day mortality and overall survival. Results Of the 15 studies included (n = 97, 898 patients), 9 studies were retrospective and included patients aged 70 years or older (n = 96, 120 patients). 5 of 12 studies reported that frailty was independently associated with the incidence of post-operative complications. There was also evidence that frailty was independently associated with 30-day mortality (1 of 4 studies, n = 9, 252 patients) and long-term survival (2 of 3 studies, n = 1, 420 patients). Conclusions Frailty was common in patients with colorectal cancer and the assessment of frailty may have prognostic value in patients undergoing surgery. However, the basis of the relationship between frailty and post-operative outcomes is not clear and merits further study.

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“…In contrast, the association between sedentary time and frailty monitored by wearable devices was inconsistent. A recently published systematic review shows that sedentary time does not affect the prevalence of frailty [32,33]. This may be due to the inconsistency in the measurement of frailty and the population.…”

Section: Discussionmentioning

confidence: 99%

Examining the Independent and Interactive Association of Physical Activity and Sedentary Behaviour with Frailty in Chinese Community-Dwelling Older Adults

Zhu

Hung

et al. 2022

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Background While physical inactivity or prolonged sitting has been linked to an increased risk of frailty, the interaction between sitting time (ST), physical activity (PA) and frailty is largely unknown. The aim of this study was to examine the independent and interactive association between PA, ST and frailty in Chinese community-dwelling older adults. Methods A cross-sectional analysis was performed on 1458 participants (age ≥ 60) enrolled from a prospective cohort study of frailty in elderly people of Fujian Province. PA and ST levels were assessed using the International Physical Activity Questionnaire. A 40-item frailty index (FI) quantified frailty. Multivariable logistic regression and linear regression models were applied to examine the independent association between PA or ST and frailty level. Interaction plots were used to visualise the interaction effects of PA and ST on frailty. Results Compared with light PA, the odds ratios (ORs) for frailty were significantly lower for moderate PA (OR, 0.609 [95% CI, 0.419, 0.885], P < .001) and vigorous PA (OR, 0.399 [95% CI, 0.236,0.673], P < .001). Comparing subjects with ST < 4 h/day, those with ST ≥ 8 h/day were significantly more likely to be diagnosed with frailty (OR, 3.140 [95% CI, 1.932, 5.106], P < .001), 6–8 h/day (OR, 1.289 [95% CI, 0.835, 1.989], P ༞0.05), and 4–6 h/day (OR, 1.400 [95% CI, 0.972, 2.018], P ༞0.05). Each one unit increase in metabolic equivalents (h/day) of PA was related to an average 0.928 (0.887, 0.971) decrease in prevalence of frailty, while each one unit increase in sitting time (h/day) was related to average 1.114 (1.046,1.185) increase in prevalence of frailty. Negative interactive effects of PA and ST on frailty were observed (P < 0.001). Conclusion PA can independently reduce the occurrence of frailty, while prolonged ST can significantly increase the occurrence of frailty. In addition, excess ST may counteract the beneficial effects of PA on frailty.

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Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review

Cited by 48 publications

References 68 publications

Associations between lifestyle factors and multidimensional frailty: a cross-sectional study among community-dwelling older people

Associations between lifestyle factors and multidimensional frailty: a cross-sectional study among community-dwelling older people

The prevalence and prognostic value of frailty screening measures in patients undergoing surgery for colorectal cancer: observations from a systematic review

Examining the Independent and Interactive Association of Physical Activity and Sedentary Behaviour with Frailty in Chinese Community-Dwelling Older Adults

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