The effectiveness of exercise on physical and cognitive function in older adults with pre-frailty or frailty: A systematic review and meta-analysis.
Dalin Luo, Xiangrong Qin, Jiabao Yan et al.
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In 30 seconds
This systematic review and meta-analysis assessed exercise effects on physical and cognitive function in pre-frail or frail older adults, pooling 37 randomized controlled trials with 3409 participants. Exercise was associated with reduced frailty scores (SMD = -0.95, 95% CI: -1.38 to -0.51, P < 0.001) and improvements in physical function and global cognition. Effects on frailty scores and SPPB were larger among frail than pre-frail participants. Evidence certainty ranged from high to very low, and substantial heterogeneity limited precision; the review did not establish that multicomponent exercise is superior to single-modality exercise.
Key findings
- Exercise reduced frailty scores (SMD = -0.95, 95% CI: -1.38 to -0.51, P < 0.001).
- Physical function improved: Grip Strength increased by 1.78 kg, gait speed by SMD = 1.10, and SPPB by 1.14 points.
- Global cognition improved (SMD = 0.67, 95% CI: 0.50-0.85, P < 0.001); cognitive flexibility and working memory also improved.
- Frail participants had larger effects on frailty scores and SPPB than pre-frail participants; evidence certainty ranged from high to very low.
Why it matters
Frailty involves both physical and cognitive decline, and the pooled findings suggest exercise may benefit both domains in older adults with pre-frailty or frailty. The reported functional gains may be clinically meaningful, but uncertainty and heterogeneity mean their magnitude is not firmly established. The findings also suggest that effects may differ by baseline frailty status.
What to keep in mind
Substantial heterogeneity limits precision, and GRADE certainty ranged from high to very low. Wide confidence intervals mean that clinically meaningful gains are likely rather than confirmed.