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Effectiveness of physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis
Megan Racey, Muhammad Usman Ali, Diana Sherifali, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Danielle R. Bouchard, Anik Giguère, Jayna Holroyd-Leduc, Ada Tang, Leah Gramlich, Heather Keller, Jeanette Prorok, Perry Kim, Amanda Lorbergs and John Muscedere; for the Canadian Frailty Network
July 13, 2021 9 (3) E728-E743; DOI: https://doi.org/10.9778/cmajo.20200222
Megan Racey
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Muhammad Usman Ali
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Diana Sherifali
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Donna Fitzpatrick-Lewis
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Ruth Lewis
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Milos Jovkovic
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Danielle R. Bouchard
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Anik Giguère
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Jayna Holroyd-Leduc
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Ada Tang
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Leah Gramlich
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Heather Keller
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Jeanette Prorok
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Perry Kim
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Amanda Lorbergs
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
John Muscedere
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller) and Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Canadian Frailty Network (Prorok, Kim, Lorbergs, Muscedere), Kingston, Ont.
Data supplements
Online appendices
Files in this Data Supplement:
- Appendix 1: Frailty and Physical Activity Search Strategies
- Appendix 2: Description of Intervention Categories and Intensities
- Appendix 3: Meta-Analysis Statistical Methods
- Appendix 4: Demographic and Characteristics of Included Studies
- Appendix 5: GRADE Tables for All Outcomes by Intervention Category
- Appendix 6: Funnel Plots
- Appendix 7: Meta-analysis Forest Plots for Outcomes
- Appendix 8: Physical Activity - Observational Study Data (N=2)
- Reviewer Comments
- Original Submission
- PRISMA Checklist
Related Articles
- Racey, M., Ali, M. U., Sherifali, D., Fitzpatrick-Lewis, D., Lewis, R., Jovkovic, M., Gramlich, L., Keller, H., Holroyd-Leduc, J., Giguère, A., Tang, A., Bouchard, D., Prorok, J., Kim, P., Lorbergs, A., & Muscedere, J. (2021). Effectiveness of nutrition interventions and combined nutrition and physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis. Canadian Medical Association Open Access Journal, 9(3), E744-E756. Accessed June 06, 2023. https://doi.org/10.9778/cmajo.20200248.
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Effectiveness of physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis
Megan Racey, Muhammad Usman Ali, Diana Sherifali, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Danielle R. Bouchard, Anik Giguère, Jayna Holroyd-Leduc, Ada Tang, Leah Gramlich, Heather Keller, Jeanette Prorok, Perry Kim, Amanda Lorbergs, John Muscedere
Jul 2021, 9 (3) E728-E743; DOI: 10.9778/cmajo.20200222
Effectiveness of physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis
Megan Racey, Muhammad Usman Ali, Diana Sherifali, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Danielle R. Bouchard, Anik Giguère, Jayna Holroyd-Leduc, Ada Tang, Leah Gramlich, Heather Keller, Jeanette Prorok, Perry Kim, Amanda Lorbergs, John Muscedere
Jul 2021, 9 (3) E728-E743; DOI: 10.9778/cmajo.20200222
