Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults

Abstract

Objectives: To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty.

Design: Longitudinal cohort study.

Setting: Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom.

Participants: A total of 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years).

Measurements: The frequency of self-reported moderate PA was measured and classified into two categories: "regular frequency" and "low frequency." The 12-month change in frequency of moderate PA between baseline and follow-up was classified into four categories: "continued regular frequency," "decreased frequency," "continued low frequency," and "increased frequency." The 15-item Tilburg Frailty Indicator assessed overall, physical, psychological, and social frailty.

Results: Participants who undertook moderate PA with a regular frequency at baseline were less frail at 12-month follow-up than participants with a low frequency. Participants who undertook moderate PA with a continued regular frequency were least frail at baseline and at 12-month follow-up. After controlling for baseline frailty and covariates, compared with participants with a continued regular frequency, participants with a decreased frequency were significantly more overall (B = 1.31; 95% confidence interval [CI] = 0.99-1.63), physically (B = 0.80; 95% CI = 0.58-1.03), psychologically (B = 0.43; 95% CI = 0.30-0.56), and socially frail (B = 0.14; 95% CI = 0.04-0.23) at 12-month follow-up; participants with a continued low frequency were significantly more overall (B = 1.16; 95% CI = 0.84-1.49), physically (B = 0.73; 95% CI = 0.51-0.96), psychologically (B = 0.42; 95% CI = 0.29-0.55), and socially frail (B = 0.13; 95% CI = 0.04-0.23) at 12-month follow-up; the 12-month follow-up frailty level of participants who undertook moderate PA with an increased frequency was similar to those with a continued regular frequency.

Conclusion: Maintaining a regular frequency of PA as well as increasing to a regular frequency of PA are associated with maintaining or improving overall, physical, psychological, and social frailty among European community-dwelling older adults older than 70 years. J Am Geriatr Soc 68:1484-1493, 2020.

Keywords: frailty; physical activity; physical frailty; psychological frailty; social frailty.

Figure 1

Frequency of moderate physical activity of participants.

Figure 2

Frailty score at baseline and follow‐up of participants from the groups of frequency of moderate physical activity (PA). (A) Baseline PA and overall frailty, (B) Change in PA and overall frailty, (C) Baseline PA and physical frailty, (D) Change in PA and physical frailty, (E) Baseline PA and psychological frailty, (F) Change in PA and psychological frailty, (G) Baseline PA and social frailty, (H) Change in PA and social frailty.