Association Between Physical Activity Patterns And Frailty In Older Adults: UK Biobank

While physical activity (PA) patterns are associated with various adverse health outcomes, the relationship between PA patterns and frailty remains understudied. PURPOSE: To examine the association between PA patterns and frailty in older adults. METHODS: This cross-sectional study included 10,082 individuals aged ≥65 years (66.8 ± 1.5 years; 49% female) from UK Biobank. Participants wore accelerometers on dominant wrist for 7 days. Acceleration in milligravity (mg) was obtained by Euclidean Norm Minus One. To characterize PA patterns, we summarized low (Q1), moderate (Q2&3) and high (Q4) PA levels based on sex-specific overall mean acceleration. We also used K-means clustering analysis to identify clusters based on hourly relative accelerations between 5 am to 10 pm (calculated as hourly mean mg/overall mean mg). Frailty was assessed using Modified Fried Frailty Phenotype. Multivariate logistic regression model was used to examine the association between PA patterns and frailty. RESULTS: Of the participants, 3527 were identified as frail. Participants were grouped into 4 clusters: 1) uniform distribution, 2) late morning active, 3) early morning active, 4) midday to afternoon active (Figure A). Compared to the high PA with uniform distribution (reference) group, the 4 low PA groups showed 1.5-2.19 times odds of frailty, while the 3 high PA groups did not show significantly different odds of frailty (Figure B). Within the moderate PA groups, the uniform distribution and early morning active groups showed 1.4-1.49 times odds of frailty, whereas the late morning and midday to afternoon active groups did not have significantly different odds of frailty compared to the reference group (Figure B). CONCLUSIONS: Older adults with low PA are more likely to be frail, regardless of their daily PA patterns. Furthermore, within the low and moderate PA groups, patterns of accumulating PA in early morning and uniformly throughout the day were associated with higher odds of frailty.