What Enables Individuals to Be More Physically Active across Levels of Frailty?

D Scott Kehler ,Mariana Gonzalez-Lara ,Andrea E Mayo ,Olga Theou

doi:10.20900/agmr20200007

Abstract

Background: Physical activity is important in the management of frailty. Here we determine if specific frailty deficits relate to lower activity across degrees of frailty, and what types of physical activities are commonly reported. Methods: Accelerometer data from 6817 adults 20–85 years old (2003–2004/2005–2006 cycles) of the National Health and Nutrition Examination Survey were analyzed. Moderate-to-vigorous intensity physical activity (MVPA) was measured in 1-minute bouts. Frailty was measured with a 46-item frailty index consisting of chronic conditions, healthcare utilization, difficulties in activities of daily living (ADL), and laboratory deficits. Individuals were stratified into frailty groups: non-frail, <0.10 (53%; n = 3610); minimally frail, 0.10–0.20 (26%; n = 1776); and frail, >0.20 (21%; n = 1431). Linear regression models adjusted for age, sex, demographics, and accelerometer wear time. Results: Among the total sample, the presence of individual deficits were generally associated with lower MVPA. The presence of more chronic conditions, ADLs, abnormal laboratory values, and greater healthcare utilization had an independent dose association with lower MVPA. The effect of frailty deficits on MVPA were attenuated when examining individuals by frailty level. The number of ADLs, but not the number of chronic conditions or number of laboratory deficits, were independently associated with a lower MVPA level across frailty levels. Healthcare use was associated with less MVPA in the lower frailty groups. The two most popular reported physical activities were walking and cycling across all frailty levels. Conclusions: Deficits in ADLs, but not chronic conditions or laboratory deficits, were consistently associated with lower MVPA across frailty levels.

Highlights

Frailty describes the variability in which people age in good or poor health [1]
The excluded sample were slightly younger than the included sample (43.1 vs 47.5), were more likely to have a lower education, and less likely to be married, There were no differences in sex, frailty index (FI), smoking status, or ethnicity between the excluded vs. included sample
The purpose of our study was to determine if individual frailty deficits were related to moderate to vigorous intensity physical activity (MVPA) when graded by frailty severity, and to determine what types of physical activities were most commonly reported in these groups

Summary

Introduction

Frailty describes the variability in which people age in good or poor health [1]. It arises as a consequence of accumulating health-related deficits over one’s lifetime, resulting from damage which goes unrepaired or unremoved across multiple physiologic systems [1]. The overall number of health deficits are likely a key contributor that hinders an individual’s ability to be physically active, it remains uncertain if there are specific vulnerabilities which make people more susceptible to be active than others. With this in mind, the objectives of this study are to determine the frailty deficits which are associated with MVPA across levels of frailty, as well as to determine what types of physical activities they report. We determine if specific frailty deficits relate to lower activity across degrees of frailty, and what types of physical activities are commonly reported

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Discussion

Conclusion