The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on January 20, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln001
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Published by Oxford University Press on behalf of the Gerontological Society of America 2009
Physical Activity as a Preventative Factor for Frailty: The Health, Aging, and Body Composition Study
1 Geriatric Research, Education and Clinical Center, Veteran's Affairs Medical Center, Durham, North Carolina
2 Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina
3 Curriculum in Human Movement Science, University of North Carolina, Chapel Hill
4 Department of Epidemiology, University of North Carolina, Chapel Hill
5 Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands
6 Department of Physical Therapy, University of Pittsburgh, Pennsylvania
7 Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina
8 Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania
9 Department of Epidemiology and Biostatistics, University of California, San Francisco
10 Department of Preventive Medicine, University of Tennessee, Memphis
11 Clinical Research Branch, National Institute on Aging, Baltimore, Maryland
12 Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Address correspondence to Matthew J. Peterson, PhD, Durham VA Medical Center, GRECC (182), 508 Fulton Street, Durham, NC 27705. Email: peter076{at}mc.duke.edu
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Abstract |
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Background.: It is unclear if physical activity (PA) can prevent or reverse frailty. We examined different doses and types of PA and their association with the onset and severity of frailty.
Methods.: Health, Aging and Body Composition (Health ABC) study participants (N = 2,964) were followed for 5 years, with frailty defined as a gait speed of less than 0.60 m/s and/or inability to rise from a chair without using one's arms. Individuals with one impairment were considered moderately frail and those with both severely frail. We examined PA doses of volume and intensity, activity types (e.g., lifestyle vs exercise activities), and their associations with incident frailty and transition to severe frailty in those who became frail.
Results.: Adjusted models indicated that sedentary individuals had significantly increased odds of developing frailty compared with the exercise active group (adjusted odds ratio [OR] = 1.45; 95% confidence interval [CI]: 1.04–2.01), whereas the lifestyle active did not. Number of diagnoses was the strongest predictor of incident frailty. In those who became frail during follow-up (n = 410), there was evidence that the sedentary (adjusted OR = 2.80; 95% CI: 0.98–8.02) and lifestyle active (adjusted OR = 2.81; 95% CI: 1.22–6.43) groups were more likely to have worsening frailty over time.
Conclusions.: Despite the strong relationship seen between comorbid conditions and onset of frailty, this observational study suggests that participation in self-selected exercise activities is independently associated with delaying the onset and the progression of frailty. Regular exercise should be further examined as a potential factor in frailty prevention for older adults.
Keywords Aging; Exercise; Frail elderly; Longitudinal studies
Received: May 3, 2007; Accepted: May 14, 2008