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Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis

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Abstract

Background

Frailty is an age-related condition that implies a vulnerability status affecting quality of life and independence of the elderly. Physical fitness is closely related to frailty, as some of its components are used for the detection of this condition.

Objectives

This systematic review and meta-analysis was conducted to investigate the magnitude of the associations between frailty and different physical fitness components and to analyse if several health-related factors can act as mediators in the relationship between physical fitness and frailty.

Methods

A systematic search was conducted of PubMed, SPORTDiscus, and Web of Science, covering the period from the respective start date of each database to March 2020, published in English, Spanish or Portuguese. Two investigators evaluated 1649 studies against the inclusion criteria (cohort and cross-sectional studies in humans aged ≥ 60 years that measured physical fitness with validated tests and frailty according to the Fried Frailty Phenotype or the Rockwood Frailty Index). The quality assessment tool for observational cross-sectional studies was used to assess the quality of the studies.

Results

Twenty studies including 13,527 participants met the inclusion criteria. A significant relationship was found between frailty and each physical fitness component. Usual walking speed was the physical fitness variable most strongly associated with frailty status, followed by aerobic capacity, maximum walking speed, lower body strength and grip strength. Potential mediators such as age, sex, body mass index or institutionalization status did not account for the heterogeneity between studies following a meta-regression.

Conclusions

Taken together, these findings suggest a clear association between physical fitness components and frailty syndrome in elderly people, with usual walking speed being the most strongly associated fitness test. These results may help to design useful strategies, to attenuate or prevent frailty in elders.

Systematic Review Registration

PROSPERO registration no. CRD42020149604 (date of registration: 03/12/2019)

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Author information

Authors and Affiliations

  1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain

    David Navarrete-Villanueva, Alba Gómez-Cabello, Jorge Marín-Puyalto, Luis Alberto Moreno, Germán Vicente-Rodríguez & José Antonio Casajús

  2. Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain

    David Navarrete-Villanueva, Alba Gómez-Cabello, Jorge Marín-Puyalto, Luis Alberto Moreno, Germán Vicente-Rodríguez & José Antonio Casajús

  3. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

    David Navarrete-Villanueva, Alba Gómez-Cabello, Jorge Marín-Puyalto, Luis Alberto Moreno, Germán Vicente-Rodríguez & José Antonio Casajús

  4. Facultad de Ciencias de la Salud, University of Zaragoza, Zaragoza, Spain

    David Navarrete-Villanueva, Luis Alberto Moreno & José Antonio Casajús

  5. Centro Universitario de la Defensa, Zaragoza, Spain

    Alba Gómez-Cabello

  6. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain

    Alba Gómez-Cabello, Luis Alberto Moreno, Germán Vicente-Rodríguez & José Antonio Casajús

  7. Facultad de Ciencias de la Salud y del Deporte, University of Zaragoza, Zaragoza, Spain

    Jorge Marín-Puyalto & Germán Vicente-Rodríguez

Authors
  1. David Navarrete-Villanueva
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  2. Alba Gómez-Cabello
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  3. Jorge Marín-Puyalto
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  5. Germán Vicente-Rodríguez
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  6. José Antonio Casajús
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Contributions

All authors contributed to the study conception and design. The literature search and data collection were performed by DNV and AGC. The data analysis was performed by DNV and JMP. The first draft of the manuscript was written by DNV and all authors critically revised and commented on the original manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to José Antonio Casajús.

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Funding

David Navarrete-Villanueva received a grant from “Gobierno de Aragón” (DGAIIU/1/20). No other sources of funding were used to assist in the preparation of this article.

Conflicts of interest/Competing interests

David Navarrete-Villanueva, Alba Gómez-Cabello, Jorge Marín-Puyalto, Luis Alberto Moreno, Germán Vicente-Rodriguez and José Antonio Casajús declare that they have no conflicts of interest relevant to the content of this review.

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Navarrete-Villanueva, D., Gómez-Cabello, A., Marín-Puyalto, J. et al. Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta-analysis. Sports Med 51, 143–160 (2021). https://doi.org/10.1007/s40279-020-01361-1

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