School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.
Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
PLoS One. 2022 Dec 1;17(12):e0278226. doi: 10.1371/journal.pone.0278226. eCollection 2022.
The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies.
A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51-0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52-0.77, 49% (ES: 0.51, 95% CI: 0.41-0.63), and 30% (ES: 0.70, 95% CI: 0.65-0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups.
This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.
身体活动（PA）与虚弱风险之间的关系尚未得出明确的结果。本系统评价通过荟萃分析旨在评估社区居住的中老年人群中 PA 对虚弱发生的影响，方法是汇总来自队列研究的数据。
通过 PubMed、Embase 和 Web of Science 系统检索文献，截至 2021 年 6 月 1 日。采用随机效应模型，通过比较 PA 最高与最低水平，计算具有 95%置信区间（CI）的汇总调整效应估计值（ES）。采用 I2 统计量和 Q 检验检测异质性。采用推荐评估、制定与评估（GRADE）方法评估证据质量。
共纳入 10 项队列研究 14 项记录，GRADE 方法将证据质量评为低。与 PA 最低水平相比，PA 最高水平与虚弱发生的几率降低 41%相关（ES：0.59，95%CI：0.51-0.67；I2=70.0%，P 异质性<0.001）。纳入研究结果合并后，按虚弱评估方法进行分层分析，PA 最高水平与身体虚弱标准、多维模型和残疾积累分别显著相关，虚弱发生几率分别降低 37%（ES 0.63，95%CI：0.52-0.77）、49%（ES：0.51，95%CI：0.41-0.63）和 30%（ES：0.70，95%CI：0.65-0.75）。PA 指标和 PA 评估工具的亚组分析也得出了类似的保护作用。
这项具有中等确定性证据的研究表明，更高水平的 PA 与虚弱发生几率降低相关，PA 对虚弱预防的益处独立于虚弱评估工具、PA 指标和 PA 评估方法。本研究结果可能有助于实施积极的运动策略来预防虚弱。
