Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Dec 1;17(12):e0278226.
doi: 10.1371/journal.pone.0278226. eCollection 2022.

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

Wenjing Zhao  1   2 , Peng Hu  3   4 , Weidi Sun  5 , Weidong Wu  6 , Jinhua Zhang  7 , Hai Deng  8 , Jun Huang  9 , Shigekazu Ukawa  10 , Jiahai Lu  3 , Akiko Tamakoshi  2 , Xudong Liu  4
Affiliations
Meta-Analysis

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

Wenjing Zhao et al. PLoS One. .

Abstract

Objective: The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies.

Methods: A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results: A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51-0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52-0.77, 49% (ES: 0.51, 95% CI: 0.41-0.63), and 30% (ES: 0.70, 95% CI: 0.65-0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups.

Conclusions: This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study selection process.
Fig 2
Fig 2. Forest plot of association between physical activity and the risk of frailty.
Fig 3
Fig 3. Funnel plots with pseudo 95% confidence limits for the association between physical activity and the risk of frailty.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Angulo J, El Assar M, Alvarez-Bustos A, Rodriguez-Manas L. Physical activity and exercise: Strategies to manage frailty. Redox Biol. 2020;35:101513. Epub 2020/04/03. doi: 10.1016/j.redox.2020.101513 . - DOI - PMC - PubMed
    1. O’Caoimh R, Sezgin D, O’Donovan MR, Molloy DW, Clegg A, Rockwood K, et al.. Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age and ageing. 2021;50(1):96–104. doi: 10.1093/ageing/afaa219 . - DOI - PubMed
    1. Collard RM, Boter H, Schoevers RA, Voshaar RCO. Prevalence of Frailty in Community-Dwelling Older Persons: A Systematic Review. J Am Geriatr Soc. 2012;60(8):1487–92. doi: 10.1111/j.1532-5415.2012.04054.x - DOI - PubMed
    1. Denfeld QE, Winters-Stone K, Mudd JO, Gelow JM, Kurdi S, Lee CS. The prevalence of frailty in heart failure: A systematic review and meta-analysis. International journal of cardiology. 2017;236:283–9. Epub 2017/02/22. doi: 10.1016/j.ijcard.2017.01.153 . - DOI - PMC - PubMed
    1. Handforth C, Clegg A, Young C, Simpkins S, Seymour MT, Selby PJ, et al.. The prevalence and outcomes of frailty in older cancer patients: a systematic review. Annals of oncology: official journal of the European Society for Medical Oncology. 2015;26(6):1091–101. Epub 2014/11/19. doi: 10.1093/annonc/mdu540 . - DOI - PubMed

Publication types