Exercise as an intervention for frailty

Authors: FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LIU, CHRISTINE - Boston University

Submitted to: Clinics in Geriatric Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/5/2011
Publication Date: 2/27/2011
Citation: Fielding, R.A., Liu, C.K. 2011. Exercise as an intervention for frailty. Clinics in Geriatric Medicine. 27(1):101-110.

Interpretive Summary: Although more investigation is still needed, most studies suggest that clinicians should recommend regular physical activity or exercise training to frail older adults. The current guidelines from the US Department of Health and Human Services state that all adults older than 65 years should participate in 150 minutes (i.e., 2.5 hours) of moderate aerobic exercise per week. Although most trials studied resistance exercise training, frail older adults are encouraged to start with an aerobic activity, such as walking, as it is more accessible. If possible, resistance exercise training should be added. Depending on the degree of frailty, supervision may or may not be required. For individuals with severe frailty, evaluation by rehabilitation professional is recommended. Most evidence shows that regular physical activity or exercise is beneficial for older adults who are frail or at high risk of frailty. Studies have shown that the number of adverse events is minimal and the gains of regular exercise clearly outweigh the risks. Although there are still several areas related to the intervention that require further investigation, regular physical activity or exercise is highly recommended for older adults as a means to modify frailty and its adverse outcomes.

Technical Abstract: By 2015, nearly 15% of the US population will be older than 65 years. In 2030, there will be more than 70 million older Americans. This increase in the elderly population has prompted interest in recent years toward the study of frail older adults. This article reviews the literature investigating the utility of aerobic and resistance exercise training as an intervention for frailty in older adults. In addition, areas of future research are addressed, including concerns related to the dissemination of exercise interventions on a widespread scale. Guidelines for an "exercise prescription" for frail older adults are briefly outlined.