Correlation Between Objectively Measured Spontaneous Physical Activity and Sedentary Behavior With Frailty Syndrome in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.

Abstract

Purpose: To analyze the correlation between spontaneous physical activity (PA) and sedentary behavior (SB) objectively measured using wearable devices and frailty syndrome (FS) in older adults.

Methods: The PubMed/Medline, Web of Science, and Cochrane Library databases were used as sources of information. The search equation used was "(accelerometer OR physical activity) AND (elderly OR 'older adult' OR older) AND (frailty) AND ('nursing home' OR institutionalized)."

Results: Twenty-three studies were included. Of these, 14 studies examining PA were eligible for meta-analysis. A random effects correlation analysis of these 14 studies revealed a significant inverse correlation between PA and FS (r = -0.48, 95% CI = [-0.5585, -0.3560], Z = -8.39, p < 0.0001), indicating statistically significant between-study variance and high heterogeneity (I ² = 84%). Regarding SB, 11 of the 16 studies were meta-analyzed. Random-effects meta-analysis showed that 8 of the 11 analyzed studies presented a significant positive association between SB and FS (r = 0.334, CI = [0.2233; 0.4259], Z = 6.67, p < 0.0001), with statistically significant between-study variance and high heterogeneity (I ² = 86.9%). Sensitivity analysis revealed that removing one study increased the inverse correlation coefficient between PA and FS from -0.33 to -0.46 and increased the positive correlation coefficient between SB and FS from 0.22 to 0.39.

Conclusion: Lower PA and high SB time are significantly associated with high FS incidence among older people. These findings highlight the importance of promoting PA and reducing SB to prevent FS and its complications in later life.