Skip to main content
Log in

Exercise and/or Dietary Varieties and Incidence of Frailty in Community-Dwelling Older Women: A 2-Year Cohort Study

  • Published:
The journal of nutrition, health & aging

Abstract

Objective

Exercise and dietary habits rich in variety may reduce the risk of frailty incident, but such association remains unexamined. This study aimed to examine the longitudinal associations between exercise and/or dietary varieties and incidence of frailty in older women.

Design

A 2-year population-based prospective cohort study.

Setting and participants

Six hundred and four community-dwelling older Japanese women aged ≥75 years with non-frailty at baseline survey.

Measurements

Frailty was assessed using Fried’s frailty criteria composed of shrinking, weakness, slowness, low activity, and exhaustion at both baseline and follow-up surveys. Frailty incident was defined as the presence of =3 components at the follow-up survey. At baseline, information about exercise and dietary habits were obtained from all participants through a face-to-face interview. Participants were grouped into two categories, high (=2) and low (<2) exercise varieties, assessed by the number of participations in 17 exercise types. By dietary variety, assessed using Dietary Variety Score (range, 0 to 10), participants were grouped into two, high (=4 points) and low (<4 points) dietary varieties. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) of the incidence of frailty in the 4 groups (low-exercise and low-dietary varieties [low EV + low DV] as reference; low-exercise and high-dietary varieties [low EV + high DV]; high-exercise and low-dietary varieties [high EV + low DV]; and high-exercise and high-dietary varieties [high EV + high DV]).

Results

Frailty incidence rate was 9.3% over the 2-year follow-up period. Incidence rates of frailty in the 4 groups were as follows: 23.7%, 10.1%, 6.5%, and 7.7% in the low EV + low DV, low EV + high DV, high EV + low DV, and high EV + high DV groups, respectively. After adjustment for covariates, only the high EV + high DV group was associated with a significantly lower OR (0.38; 95% CI 0.15–0.92) of frailty incidence compared with the low EV + low DV group.

Conclusion

Higher variety of exercise and diet was significantly associated with lower incidence of frailty. Thus, the combination of variety-rich exercise and dietary program may be useful in preventing the incidence of frailty in older women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–156.

    Article  CAS  PubMed  Google Scholar 

  2. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381:752–762. doi:10.1016/s0140–6736(12)62167–9.

    Article  PubMed  Google Scholar 

  3. Feng Z, Lugtenberg M, Franse C et al. Risk factors and protective factors associated with incident or increase of frailty among community–dwelling older adults: A systematic review of longitudinal studies. PLoS One 2017;12:e0178383. doi:10.1371/journal.pone.0178383.

    Google Scholar 

  4. Ottenbacher KJ, Graham JE, Al Snih S et al. Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Public Health 2009;99:673–679. doi:10.2105/ajph.2008.143958.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Woods NF, LaCroix AZ, Gray SL et al. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2005;53:1321–1330. doi:10.1111/j.1532–5415.2005.53405.x.

    Article  PubMed  Google Scholar 

  6. Liljas AEM, Carvalho LA, Papachristou E et al. Self–reported hearing impairment and incident frailty in English community–dwelling older adults: A 4–year follow–up study. J Am Geriatr Soc 2017;65:958–965. doi:10.1111/jgs.14687.

    Article  PubMed  Google Scholar 

  7. Liljas AEM, Carvalho LA, Papachristou E et al. Self–reported vision impairment and incident prefrailty and frailty in English community–dwelling older adults: findings from a 4–year follow–up study. J Epidemiol Community Health 2017;71:1053–1058. doi:10.1136/jech–2017–209207.

    PubMed  PubMed Central  Google Scholar 

  8. Wade KF, Lee DM, McBeth J et al. Chronic widespread pain is associated with worsening frailty in European men. Age Ageing 2016;45:268–274. doi:10.1093/ageing/afv170.

    Article  PubMed  Google Scholar 

  9. Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol 2009;103:1616–1621. doi:10.1016/j.amjcard.2009.01.375.

    Article  PubMed  Google Scholar 

  10. Garcia–Esquinas E, Graciani A, Guallar–Castillon P, Lopez–Garcia E, Rodriguez–Manas L, Rodriguez–Artalejo F. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J Am Med Dir Assoc 2015;16:748–754. doi:10.1016/j.jamda.2015.04.008.

    Article  PubMed  Google Scholar 

  11. Lakey SL, LaCroix AZ, Gray SL et al. Antidepressant use, depressive symptoms, and incident frailty in women aged 65 and older from the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2012;60:854–861. doi:10.1111/j.1532–5415.2012.03940.x.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Raji MA, Al Snih S, Ostir GV, Markides KS, Ottenbacher KJ. Cognitive status and future risk of frailty in older Mexican Americans. J Gerontol A Biol Sci Med Sci 2010;65:1228–1234. doi:10.1093/gerona/glq121.

    Article  PubMed  Google Scholar 

  13. Kojima G, Iliffe S, Jivraj S, Liljas A, Walters K. Does current smoking predict future frailty? The English longitudinal study of ageing. Age Ageing 2018;47:126–131. doi:10.1093/ageing/afx136.

    PubMed  Google Scholar 

  14. Ortola R, Garcia–Esquinas E, Leon–Munoz LM et al. Patterns of alcohol consumption and risk of frailty in community–dwelling older adults. J Gerontol A Biol Sci Med Sci 2016;71:251–258. doi:10.1093/gerona/glv125.

    Article  PubMed  Google Scholar 

  15. Peterson MJ, Giuliani C, Morey MC et al. Physical activity as a preventative factor for frailty: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci 2009;64:61–68. doi:10.1093/gerona/gln001.

    Article  PubMed  Google Scholar 

  16. Song J, Lindquist LA, Chang RW et al. Sedentary Behavior as a Risk Factor for Physical Frailty Independent of Moderate Activity: Results From the Osteoarthritis Initiative. Am J Public Health 2015;105:1439–1445. doi:10.2105/ajph.2014.302540.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Leon–Munoz LM, Guallar–Castillon P, Lopez–Garcia E, Rodriguez–Artalejo F. Mediterranean diet and risk of frailty in community–dwelling older adults. J Am Med Dir Assoc 2014;15:899–903. doi:10.1016/j.jamda.2014.06.013.

    Article  PubMed  Google Scholar 

  18. Shikany JM, Barrett–Connor E, Ensrud KE et al. Macronutrients, diet quality, and frailty in older men. J Gerontol A Biol Sci Med Sci 2014;69:695–701. doi:10.1093/gerona/glt196.

    Article  CAS  PubMed  Google Scholar 

  19. Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to mediterranean diet reduces incident frailty risk: systematic review and meta–analysis. J Am Geriatr Soc 2018;66:783–788. doi:10.1111/jgs.15251.

    Article  PubMed  Google Scholar 

  20. Wang Y, Hao Q, Su L, Liu Y, Liu S, Dong B. Adherence to the mediterranean diet and the risk of frailty in old people: A aystematic review and meta–analysis. J Nutr Health Aging 2018;22:613–618. doi:10.1007/s12603–018–1020–x.

    Article  CAS  PubMed  Google Scholar 

  21. de Labra C, Guimaraes–Pinheiro C, Maseda A, Lorenzo T, Millan–Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr 2015;15:154. doi:10.1186/s12877–015–0155–4.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Cadore EL, Rodriguez–Manas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res 2013;16:105–114. doi:10.1089/rej.2012.1397.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kim H, Suzuki T, Kim M et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community–dwelling frail Japanese women: a randomized double blind, placebo–controlled, follow–up trial. PLoS One 2015;10:e0116256. doi:10.1371/journal. pone.0116256.

    Google Scholar 

  24. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community–dwelling older persons: a systematic review. J Am Geriatr Soc 2012;60:1487–1492. doi:10.1111/j.1532–5415.2012.04054.x.

    Article  PubMed  Google Scholar 

  25. Kim H, Suzuki T, Kim M et al. Incidence and predictors of sarcopenia onset in community–dwelling elderly Japanese women: 4–year follow–up study. J Am Med Dir Assoc 2015;16:85.e81–88. doi:10.1016/j.jamda.2014.10.006.

    Article  PubMed  Google Scholar 

  26. Satake S, Shimada H, Yamada M et al. Prevalence of frailty among communitydwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatrics & Gerontology International 2017;17:2629–2634. doi:doi:10.1111/ggi.13129.

    Article  Google Scholar 

  27. Shinkai S, Watanabe S, Kumagai S et al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing 2000;29:441–446.

    Article  CAS  PubMed  Google Scholar 

  28. Osuka Y, Suzuki T, Kim M et al. Association between exercise type and the decline in instrumental activities of daily living in community–dwelling older women: A 4–year prospective study. Prev Med 2018;112:23–30. doi:10.1016/j.ypmed.2018.03.019.

    Article  PubMed  Google Scholar 

  29. Kumagai S, Watanabe S, Shibata H et al. Effects of dietary variety on declines in highlevel functional capacity in elderly people living in a community. Nihon Koshu Eisei Zasshi 2003;50:1117–1124.

    PubMed  Google Scholar 

  30. Sheehan DV, Lecrubier Y, Sheehan KH et al. The Mini–International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM–IV and ICD–10. J Clin Psychiatry 59 Suppl 1998;20:22–33;quiz 34–57.

    Google Scholar 

  31. Kahn RL, Goldfarb AI, Pollack M, Peck A. Brief objective measures for the determination of mental status in the aged. Am J Psychiatry 1960;117:326–328. doi:10.1176/ajp.117.4.326.

    CAS  PubMed  Google Scholar 

  32. Kahn RL, Miller NE. Assessment of Altered Brain Function in the Aged. In: Storandt M, Siegler IC, Elias MF, editors. The Clinical Psychology of Aging. Boston, MA: Springer US; 1978. p. 43–69.

  33. Soysal P, Isik AT, Carvalho AF et al. Oxidative stress and frailty: A systematic review and synthesis of the best evidence. Maturitas 2017;99:66–72. doi:10.1016/j. maturitas.2017.01.006.

    Article  CAS  PubMed  Google Scholar 

  34. Soysal P, Stubbs B, Lucato P et al. Inflammation and frailty in the elderly: A systematic review and meta–analysis. Ageing Res Rev 2016;31:1–8. doi:10.1016/j. arr.2016.08.006.

    Article  CAS  PubMed  Google Scholar 

  35. Wilkinson DJ, Piasecki M, Atherton PJ. The age–related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing Res Rev 2018;47:123–132. doi:10.1016/j.arr.2018.07.005.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Sandoval–Insausti H, Perez–Tasigchana RF, Lopez–Garcia E, Garcia–Esquinas E, Rodriguez–Artalejo F, Guallar–Castillon P. Macronutrients intake and incident frailty in older adults: A prospective cohort study. J Gerontol A Biol Sci Med Sci 2016;71:1329–1334. doi:10.1093/gerona/glw033.

    Article  CAS  PubMed  Google Scholar 

  37. Lana A, Rodriguez–Artalejo F, Lopez–Garcia E. Dairy consumption and risk of frailty in older adults: A prospective cohort study. J Am Geriatr Soc 2015;63:1852–1860. doi:10.1111/jgs.13626.

    Article  PubMed  Google Scholar 

  38. Garcia–Esquinas E, Rahi B, Peres K et al. Consumption of fruit and vegetables and risk of frailty: a dose–response analysis of 3 prospective cohorts of community–dwelling older adults. Am J Clin Nutr 2016;104:132–142. doi:10.3945/ajcn.115.125781.

    Article  CAS  PubMed  Google Scholar 

  39. Macdonell S, Miller J, Waters D, Houghton L. Dietary patterns in the frail elderly. Curr Nutr Rep 2016;5:65–75. doi:10.1007/s13668–016–0156–8.

    Google Scholar 

  40. Rahi B, Ajana S, Tabue–Teguo M, Dartigues JF, Peres K, Feart C. High adherence to a Mediterranean diet and lower risk of frailty among French older adults communitydwellers: Results from the Three–City–Bordeaux Study. Clin Nutr 2018;37:1293–1298. doi:10.1016/j.clnu.2017.05.020.

    Article  PubMed  Google Scholar 

  41. Leon–Munoz LM, Garcia–Esquinas E, Lopez–Garcia E, Banegas JR, Rodriguez–Artalejo F. Major dietary patterns and risk of frailty in older adults: a prospective cohort study. BMC Med 2015;13:11. doi:10.1186/s12916–014–0255–6.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Pilleron S, Ajana S, Jutand MA et al. Dietary Patterns and 12–Year Risk of Frailty: Results From the Three–City Bordeaux Study. J Am Med Dir Assoc 2017;18:169–175. doi:10.1016/j.jamda.2016.09.014.

    Article  PubMed  Google Scholar 

  43. de Haas SCM, de Jonge EAL, Voortman T et al. Dietary patterns and changes in frailty status: the Rotterdam study. Eur J Nutr 2018;57:2365–2375. doi:10.1007/s00394–017–1509–9.

    Article  PubMed  Google Scholar 

  44. Chan R, Leung J, Woo J. Dietary Patterns and Risk of Frailty in Chinese Community–Dwelling Older People in Hong Kong: A Prospective Cohort Study. Nutrients 2015;7:7070–7084. doi:10.3390/nu7085326.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Chodzko–Zajko WJ, Proctor DN, Fiatarone Singh MA et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009;41:1510–1530. doi:10.1249/MSS.0b013e3181a0c95c.

    Article  PubMed  Google Scholar 

  46. Cruz–Jentoft AJ, Landi F, Schneider SM et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 2014;43:748–759. doi:10.1093/ageing/afu115.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yosuke Osuka.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Osuka, Y., Kojima, N., Yoshida, Y. et al. Exercise and/or Dietary Varieties and Incidence of Frailty in Community-Dwelling Older Women: A 2-Year Cohort Study. J Nutr Health Aging 23, 425–430 (2019). https://doi.org/10.1007/s12603-019-1166-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-019-1166-1

Key words

Navigation