GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.
Sports Med. 2021 Jan;51(1):143-160. doi: 10.1007/s40279-020-01361-1.
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.
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.
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.
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.
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.
PROSPERO registration no. CRD42020149604 (date of registration: 03/12/2019).
衰弱是一种与年龄相关的状况，暗示着一种影响老年人生活质量和独立性的脆弱状态。身体机能与衰弱密切相关，因为其某些成分可用于检测这种情况。
本系统评价和荟萃分析旨在研究衰弱与不同身体机能成分之间的关联程度，并分析是否有几个与健康相关的因素可以作为身体机能与衰弱之间关系的中介。
对 PubMed、SPORTDiscus 和 Web of Science 进行了系统检索，涵盖了每个数据库各自开始日期至 2020 年 3 月的期间，文献发表语言为英语、西班牙语或葡萄牙语。两名调查员根据纳入标准（针对年龄≥60 岁的人群进行的队列和横断面研究，使用经过验证的测试测量身体机能，并根据 Fried 衰弱表型或 Rockwood 衰弱指数测量衰弱）评估了 1649 项研究。使用观察性横断面研究质量评估工具来评估研究的质量。
有 20 项研究纳入了 13527 名参与者，符合纳入标准。发现衰弱与每个身体机能成分之间存在显著关系。常用步行速度是与衰弱状态最密切相关的身体机能变量，其次是有氧能力、最大步行速度、下肢力量和握力。元回归分析显示，年龄、性别、体重指数或机构化状态等潜在中介因素并不能解释研究之间的异质性。
综上所述，这些发现表明身体机能成分与老年人衰弱综合征之间存在明显关联，常用步行速度是与身体机能最密切相关的测试。这些结果可能有助于设计有用的策略，减轻或预防老年人衰弱。
PROSPERO 注册号 CRD42020149604（注册日期：2019 年 12 月 3 日）。
