Relationship between Physical Performance and Frailty Syndrome in Older Adults: The Mediating Role of Physical Activity, Sedentary Time and Body Composition

Abstract

The objectives were to clarify whether the relationship between physical performance and frailty was independently and jointly mediated by movement behaviors and body composition. We analyzed 871 older adults (476 women) from The Toledo Study for Healthy Aging. Skeletal muscle index (SMI) and fat index (FI) were determined using bone densitometry. Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. The Frailty Trait Scale and The Short Physical Performance Battery (SPPB) were used to evaluate frailty and physical performance, respectively. Simple and multiple mediation analyses were carried out to determine the role of movement behaviors and body composition, adjusted for potential confounders. ST and MVPA acted independently as mediators in the relationship between SPPB and frailty (0.06% for ST and 16.89% for MVPA). FI also acted as an independent mediator in the same relationship (36.47%), while the mediation role of SMI was not significant. MVPA and FI both acted jointly as mediators in this previous relationship explaining 58.15% of the model. Our data support the fact that interventions should simultaneously encourage the promotion of MVPA and strategies to decrease the FI in order to prevent or treat frailty through physical performance improvement.

The Parallel Mediation Effects of Depression, Well-Being, and Social Activity on Physical Performance and Frailty in Community-Dwelling Middle-Aged and Older People

“…The association between physical performance and depression was negative and significant, as was the relation between physical performance and frailty. These findings are consistent with previous studies, which found that physical performance was negatively associated with depression scores [ 13 , 29 , 32 ]. Other studies have found four functional limitations associated with frailty: (1) physical functioning, (2) activities of daily living, (3) instrumental activities of daily living (IADL), and (4) constraints on social participation [ 33 ].…”

“…The literature documents associations between frailty and these three additional variables. For example, a study that examined the relationship between frailty and physical performance (i.e., movement, behavior, and body composition) found that it was mediated by a person's physical activity, with sedentary time and moderate-to-vigorous physical activity acting independently as mediators [ 13 ]. A study of the association between frailty and cognitive function found that it was mediated by psychological distress; those suffering higher levels of psychological distress had higher rates of frailty [ 14 ].…”

The Effect of a Mixed Circuit of Aerobic and Resistance Training on Body Composition in Older Adults—Retrospective Study

“…The WHO also recommends varied multicomponent physical activity that emphasizes functional balance and strength training at moderate or greater intensity, on three or more days a week, to enhance functional capacity and to prevent falls [ 32 ]. Regular, moderate physical activity of older people improves their physical performance and helps prevent the frailty syndrome [ 33 ]. An example of mixed training is our mixed circuit, which consists of eight strength exercises to strengthen the main muscle groups and two aerobic exercises (cross walker and ergometer).…”

Assessment of Physical Fitness and Risk Factors for the Occurrence of the Frailty Syndrome among Social Welfare Homes’ Residents over 60 Years of Age in Poland

“…The authors found a significantly adverse correlation between the results of both measures. A lower score on the SPPB test was related to a higher score on the FTS test and higher intensity of frailty syndrome [ 50 ].…”