Xuxi Zhang

ABSTRACT Objectives To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological and social frailty among community ‐ dwelling older adults older than 70 years. Second, we assessed the association between a 12 ‐ month change in frequency of moderate PA and frailty. Design Longitudinal cohort study. Setting Community settings in Spain, Greece, Croatia, the Netherlands and the United Kingdom. Participants 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years). Measurements The frequency of self ‐ reported moderate PA was measured and classified into two categories: ‘regular frequency’ and ‘low frequency’. The 12 ‐ month change in frequency of moderate PA between baseline and follow ‐ up was classified into four categories: ‘continued regular frequency’, ‘decreased frequency’, ‘continued low frequency’ and ‘increased frequency’. The 15 ‐ item Tilburg Frailty Indicator assessed overall, physical, psychological and social frailty. Results Participants who undertook moderate PA with a regular frequency at baseline were less frail at 12 ‐ month follow ‐ up than participants with a low frequency. Participants who undertook moderate PA with a continued regular frequency were least frail at baseline and at 12 ‐ month follow ‐ up. After controlling for baseline frailty and covariates, compared with participants with a continued regular frequency, participants with a decreased frequency were significantly more overall (B = 1.31; 95%CI = 0.99,1.63), physically (B = 0.80; 95%CI = 0.58,1.03), psychologically (B = 0.43; 95%CI = 0.30,0.56) and socially frail (B = 0.14; 95%CI = 0.04,0.23) at 12 ‐ month follow ‐ up; participants with a continued low frequency were significantly more overall (B = 1.16; 95%CI = 0.84,1.49), physically (B = 0.73; 95%CI = 0.51,0.96), psychologically (B = 0.42; 95%CI = 0.29,0.55) and socially frail (B = 0.13; 95%CI = 0.04,0.23) at 12 ‐ month follow ‐ up; the 12 ‐ month follow ‐ up frailty level of participants who undertook moderate PA with an increased frequency was similar to those with a continued regular frequency. Conclusions Maintaining a regular frequency of PA as well as increasing to a regular frequency of PA are associated with maintaining or improving overall, physical, psychological and social frailty among European community ‐ dwelling older adults older than 70 years. KEYWORDS Physical activity; Frailty; Physical frailty; Psychological frailty; Social frailty 52 Chapter 3