PMC  PDF ISSUE 10(4)
Original Article
J Frailty Sarcopenia Falls 2025 Dec; 10(4):218-228 Copied!
10.22540/JFSF-10-218 Copied!

Frailty and Physical Activity: A Compositional Isotemporal Substitution Analysis from the All of Us Research Program
  1. Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
  2. Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  3. Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA


Abstract
Objectives:
The objective of this study was to quantify the impact of shifting time away from sedentary behavior to physical activity on frailty in older adults.
Methods:
Participants from the All of Us Research Program with Fitbit data were included in the analysis. Fitbit data was used to measure time spent in sleep, sedentary behavior, light-intensity physical activity, and moderate-to-vigorous physical activity. Frailty was assessed using a 33-item frailty index. A compositional isotemporal substitution model was created to assess the estimated effects of substituting 30 minutes of sedentary behavior with an equal amount of time in physical activity on frailty.
Results:
Reductions in frailty index were seen by shifting 30 minutes from sedentary behavior to light activity (-0.003 [95% CI: -0.004, -0.002]) and moderate-to-vigorous activity (-0.016 [-0.017, -0.014]). Lower odds of frailty were also seen from shifting time from sedentary behavior to light activity or moderate-to-vigorous activity. Associations between physical activity and frailty were generally more pronounced in those participants who were frail or pre-frail than in those who were robust.
Conclusions:
Shifting time from sedentary behavior to physical activity is associated with lower odds of frailty, and shifting time to higher intensity activities may have a greater benefit to frailty.
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