Relationship between Physical Performance and Frailty Syndrome in Older Adults: The Mediating Role of Physical Activity, Sedentary Time and Body Composition.

Irene Rodríguez-Gómez,José Losa-Reyna,Francisco J García-García,Asier Mañas,Luis M Alegre,Leocadio Rodríguez-Mañas,Ignacio Ara

doi:10.3390/ijerph18010203

Abstract

The objectives were to clarify whether the relationship between physical performance and frailty was independently and jointly mediated by movement behaviors and body composition. We analyzed 871 older adults (476 women) from The Toledo Study for Healthy Aging. Skeletal muscle index (SMI) and fat index (FI) were determined using bone densitometry. Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. The Frailty Trait Scale and The Short Physical Performance Battery (SPPB) were used to evaluate frailty and physical performance, respectively. Simple and multiple mediation analyses were carried out to determine the role of movement behaviors and body composition, adjusted for potential confounders. ST and MVPA acted independently as mediators in the relationship between SPPB and frailty (0.06% for ST and 16.89% for MVPA). FI also acted as an independent mediator in the same relationship (36.47%), while the mediation role of SMI was not significant. MVPA and FI both acted jointly as mediators in this previous relationship explaining 58.15% of the model. Our data support the fact that interventions should simultaneously encourage the promotion of MVPA and strategies to decrease the FI in order to prevent or treat frailty through physical performance improvement.

Highlights

It has been estimated that population aging will continue to increase until it rises to a value of 16% in the year 2050 [1]
In order to test the relationships among Frailty Trait Scale (FTS), Short Physical Performance Battery (SPPB), movement behavior variables and body composition variables adjusted for age, sex and educational status before conducting the mediation analysis, partial correlations were carried out (Table 2)
SPPB was positively associated with moderate-to-vigorous physical activity (MVPA) (0.182), and negatively associated with FTS (−0.594), sedentary time (ST) (−0.097) and fat index (FI)

Summary

Introduction

It has been estimated that population aging will continue to increase until it rises to a value of 16% in the year 2050 [1]. One of the major problematic manifestations in older adults is frailty [3], which is acknowledged as a biological condition that produces a poor resolution of several physiological systems to maintain homoeostasis after a low-power stressor event [2,4]. This syndrome leads to loss of physical performance and dependence, which may negatively affect social and psychological abilities [5].

Objectives

Methods

Results

Discussion

Conclusion