Abstract
SummaryBackgroundFrailty is a geriatric syndrome, which is highly prevalent in community-dwelling older adults and is associated with a variety of unwanted health outcomes, including dependency and institutionalization. Physical activity (PA) interventions may be of great importance in frail people to improve the frailty status, muscle strength, physical performance and muscle mass.MethodsA narrative review of randomized-controlled trails was performed, including frail and prefrail community-dwelling older adults. Included were studies with different PA interventions, such as aerobic activity, strength and balance training, stretching, and a combination of these methods.ResultsOverall, 14 studies were included. The PA interventions led to a significant reduction in the frailty status (3/5 studies), to an increase in muscle strength (4/8 studies), to improved physical performance (7/11 studies), and to an increase in muscle mass (1/4 studies), when compared to the control group. The studies analyzed differed in various aspects of study protocols (training protocol, intensity, frequency, follow-up time, measuring tools) and delivery method of intervention (health professionals, lay volunteers, at home in health care institutions).ConclusionsAlthough it was not consistently reported in the studies that PA interventions are successful in increasing muscle mass in frail and prefrail older people, the results support the effectiveness of PA interventions on the reduction of frailty, and the increase in muscle strength and physical performance.
Highlights
With the demographic shift and the rising of population age in most continental world regions [1], the health burden of aging-related morbidities presents as a major public health issue [2]
In terms of the control group interventions, two studies had an active control group, while the rest did not provide any additional support to the controls
In the muscle strength outcome there is limited evidence of the effectiveness of Physical activity (PA) interventions, while there seems to be no evidence to support the increase in muscle mass in frail or prefrail older people through PA interventions
Summary
With the demographic shift and the rising of population age in most continental world regions [1], the health burden of aging-related morbidities presents as a major public health issue [2]. In order to conceptualize the influence of a variety of factors associated with aging-related outcomes, the concept of frailty has been proposed [3]. The most commonly accepted concept of frailty is the frailty phenotype of the Cardiovascular Health Study (CHS), in which frailty is defined as the presence of minimum 3–5 different criteria; unintentional weight loss, self-reported exhaustion, weakness, slow walking speed and low physical activity [5]. The pathway and the pathophysiological development of frailty is not known, this geriatric syndrome has been named as a predictor of numerous adverse health-related outcomes including mobility decrease and cognitive decline, lower quality of life, high frequency of falls, hospital and nursing home admissions, various morbidities as well as overall mortality ([5,6,7]; Fig. 1). Frailty status, muscle strength, physical performance, and muscle mass are among the measurable indicators of frailty (Fig. 1)
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