A169: Association Between Daily Steps and Frailty in Older Adults: A Meta-Analysis

Background/Purpose: Frailty is a significant health challenge for the aging population, increasing vulnerability to adverse health outcomes such as chronic disease, falls, disability, and mortality. Early detection and monitoring of frailty are critical for effectively managing frailty. Daily steps, as a measure of physical activity, hold valuable information about health status and may serve as an indicator of frailty. This study aimed to examine the association between daily steps and frailty in older adults. Method: PubMed, SPORTDiscus, and Web of Science databases were searched for published studies up to June 2023. The search terms were ("daily step" or "steps per day" or "step count" or "number of steps" or "step volume") AND ("frailty" or "frail" or "pre-frailty" or "pre-frail" or "prefrailty" or "prefrail"). The inclusion criteria were peer-reviewed articles in English involving older adults aged ≥ 65 years, device-measured daily steps, and reported frailty status. Pooled estimates of mean differences with 95% confidence intervals (CI) between frailty groups (non-frail, prefrail, frail) were obtained using random-effects models. The prefrail and frail groups were combined in the primary analysis. Results: Thirteen articles comprising 3,383 participants (71.21 ± 6.69 years, 75.58% female, 42.45% prefrail and frail) were included in the analysis. Daily steps were significantly lower in the prefrail and frail combined group compared to the non-frail group (MD = 2,008, 95% CI: 1,003, 3,013, I2 = 86%). This association was consistent across subgroups stratified by health conditions, regions, wearables placement, and frailty measurement. Further analyses within the three frailty groups revealed that the prefrail group accumulated 995 steps/day (95% CI: 407, 1,582, I2 = 73%) less than the non-frail group, but 947 steps/day (95% CI: 567, 1,327, I2 = 32%) more than the frail group. Conclusion/Discussion: Current evidence suggested that older adults with frailty tend to have lower daily steps compared to non-frail older adults. Daily steps may be an indicator of frailty status in older adults.