The Association Between Physical Activity And Frailty Among The Community-Dwelling Older Adults

Objective 1)to analyze the current status of studies related to frailty among the community-dwelling older adults and explore the influence factors of frailty using visualizing method.2)to systematically review the impact of physical activity on the risk of frailty among the community-dwelling older adults,and understanding the relationship between physical activity and the risk of frailty.3)to investigate the impact of different physical activity intensity,physical activity volume and daily walking time on the risk of frailty with cross-sectional data from Japan Gerontological Evaluation Study at Taisetsu community Hokkaido in 2014(JAGES ATTACH 2014).Method 1)we searched Web of Science database to identify studies about the frailty among community-dwelling older adults.After an initial screening,the search records were imported to CiteSpace 5.3.R3 software.We summarized the current status and explored the influence factors based on the publication date,journals,countries,and keywords of included studies.2)we systematically retrieves PubMed,Cochrane Library,Embase,CNKI,Wanfang,and VIP databases,to include cohort studies and cross-sectional studies which focused on the relationship between physical activity and the risk of frailty.We assessed the methodological quality of included studies with modified Newcastle-Ottawa Scale.We presented the results of our studies with qualitative systematic review.3)we conducted a cross-sectional study based on the data from JAGES ATTACH 2014.Multiple Logistic regression analysis was performed using JMP 13 the window version(SAS Institute Inc.,Cary,NC,USA)software to predict the relationship between different physical activity intensity(inactive: participants reported neither vigorous nor moderate intensity of physical activity,moderate intensity: participants reported moderate physical activity,vigorous intensity: participants reported they did vigorous physical activity or both moderate and vigorous physical activity: participants reported they did both moderate and vigorous physical activity),physical activity volumes(inactive: 0 MET × minutes per week,light: <600 MET × minutes per week,moderate: 600-3000 MET × minutes per week,and high: >3000 MET × minutes per week),and daily walking time(low: daily walking<0.5 h,moderate: daily walking 0.5~1h,and high: daily walking>1h)and the risk of frailty in the community-dwelling older adults.Results 1)visualizing study: a total of 1502 studies were included,the results showed that the hotspots of frailty among community-dwelling older adults were mainly focused on the following three aspects,including screening and assessment of high-risk frailty,the intervention model and effectiveness assessment,and prevalence,risk and the association analysis.What's more,the frontier of research is the effect of physical activity and comprehensive care in postpone or reverse frailty.2)systematic review: we totally included 10 studies about physical activity and the risk of frailty,four of them are cohort studies and another six are cross-sectional studies.Most included studies(90%)were conducted in Europe and America,and only Japan in the Asian area.Quality evaluation results showed that the quality of the included studies was acceptable,and the results of both of the cohort study and cross-sectional studies suggested that a sedentary lifestyle could increases the risk of frailty,and higher physical activity could decrease the risk of frailty.3)Cross-sectional study: the analysis totally included 706 participants,and the results showed that the prevalence of frailty among community-dwelling older adults in Japan was 16.4%.Compared with low intensity physical activity,higher intensity physical activity could effectively reduce the risk of frailty(moderate intensity: OR=0.32,95%CI: 0.35,0.99;vigorous intensity: OR=0.59,95%CI: 0.35,0.98).A higher volume physical activity could effectively reduce the risk of frailty(moderate volume: OR=0.31,95%CI: 0.17,0.57;high volume: OR=0.35,95%CI: 0.19,0.66)compared with low volume physical activity.More than 0.5 hour walking daily also could reduce the risk of frailty than <0.5 hours(0.5-1 hours daily walking:OR=0.35,95%CI: 0.18,0.68;more than 1 hours daily walking: OR=0.41,95%CI: 0.22,0.75).Conclusions One of the current research hotspot and frontier were the association between physical activity and the risk of frailty.Higher intensity physical activity,higher volumes physical activity,and daily walking for >0.5 hours could reduce the risk of frailty among community-dwelling older adults.However,because the studies in this field were mainly conducted in Europe and the United States,and our cross-sectional data was from Japan,it is urgent to produce localized and high-quality evidence for Chinese decision-makers,and provide scientific evidence for promoting the healthy aging in China.