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

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SYSTEMATIC REVIEW

Frailty and Physical Fitness in Elderly People: A Systematic Review and Meta‑analysis David Navarrete‑Villanueva1,2,3,4   · Alba Gómez‑Cabello1,2,3,5,6   · Jorge Marín‑Puyalto1,2,3,7   · Luis Alberto Moreno1,2,3,4,6   · Germán Vicente‑Rodríguez1,2,3,6,7   · José Antonio Casajús1,2,3,4,6 

© Springer Nature Switzerland AG 2020

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)

Key Points  Physical fitness components are strongly associated with frailty. Usual walking speed is the physical fitness test most strongly associated with frailty status.

Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s4027​9-020-01361​-1) contains supplementary material, which is available to authorized users. * José Antonio Casajús [email protected] Extended author information available on the last page of the article Vol.:(0123456789)



1 Introduction The life expectancy of humans has continuously increased in most countries