Association Between Physical Activity Trajectories and Frailty in Older Adults: Evidence from the Health and Retirement Study

Ran Yan^1*雅文 尹¹Yizhen Hu¹Juxiang Yang¹Hongchu Wang²Yi Wang³Gang Song^1*

• ¹Southwest University, Chongqing, China
• ²South China Normal University, Guangzhou, China
• ³Renmin University of China, Beijing, China

Objective: To examine the association between long-term physical activity (PA) trajectories and the risk of frailty among middle-aged and older adults. Design: Prospective cohort analysis of the Health and Retirement Study (HRS, 2006–2018). PA patterns were identified using group-based trajectory modeling. Linear mixed-effects models and logistic regression analyses were employed to examine the associations between physical activity trajectories and changes in the frailty index, as well as the risk of incident frailty. Setting: Nationally representative community-dwelling adults in the United States. Participants: 14,843 individuals aged ≥50 years with complete PA and frailty data from Waves 8–14. Results: Five PA trajectories were identified: low decreasing (15.6%), moderate decreasing (36.8%), moderate increasing (14.7%), high decreasing (10.2%), and high stable (22.7%). At baseline, the high stable group had the youngest mean age (64.7 ± 9.5 years), lowest depressive symptoms (CES-D: 0.9 ± 1.5), and lowest BMI (27.4 ± 5.1), all with P < 0.001. Compared with the low decreasing group, all other groups exhibited significantly slower progression of frailty index scores and a reduced risk of incident frailty. Adjusted odds ratios (OR) for frailty were as follows: moderate decreasing group, 0.54 (95% CI, 0.47 to 0.61); moderate increasing group, 0.28 (95% CI, 0.23 to 0.34); high decreasing group, 0.18 (95% CI, 0.14 to 0.24); and high stable group, 0.17 (95% CI, 0.14 to 0.21). Conclusions: Participation in moderate to high levels of PA trajectories is significantly associated with a lower risk of frailty onset and a slower progression of frailty.