The Influence of Lifestyle Behaviors on the Incidence of Frailty

Abstract

Background: Frailty is a clinical state defined as an increase in an individual’s vulnerability to developing adverse health-related outcomes. Objectives: We propose that healthy behaviors could lower the incidence of frailty. The aim is to describe the association between healthy behaviors (physical activity, vaccination, tobacco use, and cancer screening) and the incidence of frailty. Design: This is a secondary longitudinal analysis of the Mexican Health and Aging Study (MHAS) cohort. Setting: MHAS is a population-based cohort, of community-dwelling Mexican older adults. With five assessments currently available, for purposes of this work, 2012 and 2015 waves were used. Participants: A total of 6,087 individuals 50-year or older were included. Measurements: Frailty was defined using a 39-item frailty index. Healthy behaviors were assessed with questions available in MHAS. Individuals without frailty in 2012 were followed-up three years in order to determine their frailty incidence, and its association with healthy behaviors. Multivariate logistic regression models were used to assess the odds of frailty occurring according to the four health-related behaviors mentioned above. Results: At baseline (2012), 55.2% of the subjects were male, the mean age was 62.2 (SD ± 8.5) years old. The overall incidence (2015) of frailty was 37.8%. Older adults physically active had a lower incidence of frailty (48.9% vs. 42.2%, p< 0.0001). Of the activities assessed in the adjusted multivariate models, physical activity was the only variable that was independently associated with a lower risk of frailty (odds ratio: 0.79, 95% confidence interval 0.71-0.88, p< 0.001). Conclusions: Physically active older adults had a lower 3-year incidence of frailty even after adjusting for confounding variables. Increasing physical activity could therefore represent a strategy for reducing the incidence of frailty. Other so-called healthy behaviors were not associated with incident frailty, however there is still uncertainty on the interpretation of those results.

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

“…Yu et al [ 30 ] reported the studies from three prospective cohorts in Hong Kong, Taiwan-urban and Taiwan-rural, so we divided this study into three cohorts for meta-analysis; Yuki et al [ 28 ] evaluated the relationship between three dimensions of physical activity (daily number of walking steps, time of light-intensity physical activity, and time of moderate-to-vigorous intensity physical activity) and frailty risk among Japanese, and therefore we divided it into three records when doing meta-analysis. Among the other eight included studies, two studies were from Finland [ 21 , 27 ], two from the UK [ 26 , 29 ], one from Japan [ 25 ], one from the USA [ 24 ], one from Mexico [ 20 ], and one from Spain [ 19 ]. A total of 34,943 participants were included in this meta-analysis.…”

“…However, epidemiological studies on the relationship between PA and frailty did not reach to a consistent conclusion. For instance, Trombetti [ 18 ] and Pérez-Tasigchana [ 19 ] did not find any association between PA and frailty, while Borda [ 20 ] and Savela [ 21 ] reported that PA was a protective factor for frailty. A meta-analysis found that physical exercise therapy could improve mobility and physical functioning in elderly patients suffering from mobility problems, disability and/or multi-morbidity [ 22 ]; however, more original studies have been reported in the following decade, making it necessary to update the synthetic evidence.…”

Associations of physical activity participation trajectories with subsequent motor function declines and incident frailty: A population-based cohort study

“…Data from UK cohort study showed that active participants had a lower risk of frailty compared with inactive participants (43). Borda et al also reported that PA was significantly associated with a lower risk of developing frailty in the Mexican Health and Aging Study cohort (44). Based on mobile healthcare and wearable technologies, Li et al found that for 1 SD decrease in the temporal activity (more random activity fluctuations) correlations the risk of frailty increased by 31%; the risk of disability increased by 15-25%; and the risk of death increased by 26% (45).…”

What Is the Relationship between Lifestyle and Frailty Status? Data from the Portuguese Multicentre Descriptive Study

“…Ageing does not inevitably lead to frailty; however, frailty usually intensifies with advancing age [ 1 , 2 , 3 ]. Other determinants of frailty have also been identified, including genetics, consequences of acute or traumatic pathologies, and unhealthy lifestyles [ 4 , 5 ]. These determinants can be potentiated by inflammatory and immunological mechanisms, leading to the appearance of typical frailty symptoms, with subsequent adverse results, such as falls, disability, and dependence [ 6 ].…”