Reallocating Accelerometer-Assessed Sedentary Time to Light or Moderate- to Vigorous-Intensity Physical Activity Reduces Frailty Levels in Older Adults: An Isotemporal Substitution Approach in the TSHA Study
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Introduction The effects of replacing sedentary time with light or moderate- to vigorous-intensity physical activity on frailty are not well known. Aim To examine the mutually independent associations of sedentary time (ST), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) with frailty status in older adults. Methods A total of 628 people aged ≥65 years from the Toledo Study of Healthy Aging (TSHA) participated in this cross-sectional study. Frailty was measured using the Frailty Trait Scale. Hip-worn accelerometers were used to capture objective measurements of ST, LPA, and MVPA. Linear regression and isotemporal substitution analyses were used to examine associations of ST, LPA, and MVPA with frailty status. Analyses were also stratified by comorbidity. Results In single and partition models, LPA and MVPA were negatively associated with frailty. Time in sedentary behavior was not associated with frailty in these models. In the isotemporal substitution models, replacing 30 minutes/d of ST with MVPA was associated with a decrease in frailty [β -2.460; 95% confidence interval (CI): -3.782, -1.139]. In contrast, replacing ST with LPA was not associated with favorable effects on this outcome. However, when the models were stratified by comorbidity, replacing ST with MVPA had the greatest effect on frailty in both the comorbidity (β -2.556; 95% CI: -4.451, -0.661) and the no comorbidity group (β -2.535; 95% CI: -4.343, -0.726). Moreover, the favorable effects of LPA in people with comorbidities was found when replacing 30 minutes/d of ST with LPA (β -0.568; 95% CI: -1.050, -0.086). Conclusions Substituting ST with MVPA is associated with theoretical positive effects on frailty. People with comorbidity may also benefit from replacing ST with LPA, which may have important clinical implications in order to decrease the levels of physical frailty.
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Replacing 30 minutes per day of sedentary time with moderate to vigorous physical activity has been associated with decreased frailty in older people.
“In addition, replacing 30 minutes per day of sedentary time with moderate to vigorous physical activity has been associated with a decreased frailty in older people (86).”
From Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations (2020) · cites this paper as [86]
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- Authors
- Mañas, A., del Pozo-Cruz, B., Guadalupe-Grau, A., Marín-Puyalto, J., Alfaro-Acha, A., Rodríguez-Mañas, L., García-García, F. J., & Ara, I.
- Affiliations
- Centro de Investigación Biomédica en Red (ES)
- Universidad de Zaragoza (ES)
- Corresponding author
- Ara, Ignacio
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 19
- Issue
- 2
- Pages
- 185.e1-185.e6
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2781068560
- Cited by
- 86
- References
- 48
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 10 · 2020: 11 · 2019: 16 · 2018: 5
- FWCI
- 5.31
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- RUIdeRA - Institutional University Repository (University of Castilla-La Mancha) (submittedVersion, other-oa)
- Funders
- Consejería de Sanidad de Castilla-La Mancha (03031-00)
- Ministerio de Economía y Competitividad
- Junta de Comunidades de Castilla-La Mancha (PI2010/020)
- Instituto de Salud Carlos III (PI031558, PI10/01532, PI11/01068)
- Seventh Framework Programme
- Universidad de Castilla-La Mancha (2015/4062)
- European Regional Development Fund
- European Commission (CB16/10/00477)
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- sedentary behavior, frailty, older adults, light physical activity, moderate-to-vigorous physical activity, isotemporal substitution, accelerometer-measured activity, comorbidities, healthy aging, hip-worn accelerometers, sedentary time reduction, physical activity promotion, sedentary time
- MeSH terms
- Frailty, Aged, Female, Humans, Male, Spain, Exercise, Sedentary Behavior, Accelerometry
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