Physical Activity and Mobility Impairment Across the Frailty Spectrum Among the Oldest Old: Insights From the Brazilian Longitudinal Study of Aging (ELSI-Brazil)

Abstract

This study analyzed data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) to examine the prevalence of frailty and its association with physical activity (PA) and mobility impairments in a nationally representative sample of older adults aged 80 and older in Brazil. ELSI-Brazil is a national resource that investigates aging-related health, psychosocial, and economic factors to inform public policies promoting healthy aging. Data from 1,171 participants were analyzed using chi-square tests, ANOVA, and logistic regression adjusted for confounders. About 14% were classified as frail, 73% as pre-frail, and 13% as robust. Frail individuals were less likely to meet PA guidelines (OR = 12.95; 95% CI [6.44–26.08]) and had higher odds of short-distance walking impairment (OR = 1.88; 95% CI [1.02–3.48]) compared to their robust counterparts. Our findings suggest a relatively low prevalence of frailty among Brazil’s oldest old but indicated a significant association with physical inactivity and mobility impairment.

Keywords

disability geriatric syndrome functional limitation motor behavior

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References

Ainsworth

B. E.

Haskell

W. L.

Whitt

M. C.

Irwin

M. L.

Swartz

A. M.

Strath

S. J.

O’Brien

W. L.

Bassett

Schmitz

K. H.

Emplaincourt

P. O.

Jacobs

Leon

A. S.

(2000). Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32(9 Suppl), S498–S504. https://doi.org/10.1097/00005768-200009001-00009

Batistoni

S. S. T.

Néri

A. L.

Cupertino

A. P.

(2010). Validity and reliability of the Brazilian version of the Center for Epidemiological Scale - Depression (CES-D) in Brazilian elderly. Psico-USF, 15(1), 13–22. https://doi.org/10.1590/S1413-82712010000100003

Benedetti

T. R. B.

Antunesde

P.C.

Rodriguez-Añez

C. R.

Mazo

G. Z.

Petroski

É. L.

(2007). Reproducibility and validity of the International Physical Activity Questionnaire (IPAQ) in elderly men. Revista Brasileira de Medicina Do Esporte, 13(1), 11–16. https://doi.org/10.1590/S1517-86922007000100004

Brasil. Ministério da Saúde. Secretaria de Atenção Primária à Saúde . (2021). Guia de atividade física para a população Brasileira. Ministério da Saúde. Available from. https://bvsms.saude.gov.br/bvs/publicacoes/guia_atividade_fisica_populacao_brasileira.pdf

Canevelli

Jackson-Tarlton

Rockwood

(2024). Frailty for neurologists: Perspectives on how frailty influences care planning. The Lancet Neurology, 23(11), 1147–1157. https://doi.org/10.1016/S1474-4422(24)00291-6

Cesari

Calvani

Marzetti

(2017). Frailty in older persons. Clinics in Geriatric Medicine, 33(3), 293–303. https://doi.org/10.1016/j.cger.2017.02.002

Chagas

J. M.

Santos

E. H. R.

Ronchi

C. F.

Biagini

A. P.

(2023). Sleep and life quality in frail elderly – A narrative review. Sleep Science, 16(01), 102–116. https://doi.org/10.1055/s-0043-1767742

Chou

C.-P.

Chen

K.-M.

Tung

H.-T.

Belcastro

Hsu

H.-F.

(2022). Physical fitness and frailty status of frail older adults in long-term care facilities after acupunch exercises: A cluster-randomized controlled trial. Experimental Gerontology, 163, 111799. https://doi.org/10.1016/j.exger.2022.111799

Chowdhury

S. R.

Chandra

Sunna

T. C.

Beyene

Hossain

(2023). Global and regional prevalence of multimorbidity in the adult population in community settings: A systematic review and meta-analysis. EClinicalMedicine, 57, 101860. https://doi.org/10.1016/j.eclinm.2023.101860

10.

Cohen

C. I.

Benyaminov

Rahman

M. M.

Ngu

Reinhardt

(2023). Frailty. The Medical Clinics of North America, 107(1), 183–197. https://doi.org/10.1016/j.mcna.2022.04.006

11.

Concha-Cisternas

Vásquez-Gómez

Castro-Piñero

Peterman-Rocha

Parra-Soto

Matus Castillo

C. A.

Garrido-Méndez

Poblete-valderrama

Celis-Morales

(2022). Levels of physical activity and sitting time in elderly people with fragility: Results of the 2016-2017 National Health Survey. Nutrición Hospitalaria, 40(1), 28–34. https://doi.org/10.20960/nh.04335

12.

Court

Capkova

Pająk

Tamosiunas

Bobák

Pikhart

(2025). Frailty index is an independent predictor of all-cause and cardiovascular mortality in Eastern Europe: A multicentre cohort study. Journal of Epidemiology and Community Health, 79(1), 56–63. https://doi.org/10.1136/jech-2023-221761

13.

Craig

C. L.

Marshall

A. L.

Sjostrom

Bauman

A. E.

Booth

M. L.

Ainsworth

B. E.

Pratt

Ekelund

Yngve

Sallis

J. F.

Oja

(2003). International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB

14.

Da Silva

S. L. A.

De Brito

G. E. G.

Ygnatios

N. T. M.

De Melo Mambrini

J. V.

Lima-Costa

M. F.

Torres

J. L.

(2024). Differences between men and women in the prevalence of frailty and associated factors among older adults: Evidence from ELSI-Brazil. Cadernos de Saude Publica, 40(3), Article e00144923. https://doi.org/10.1590/0102-311XPT144923

15.

de Azeredo Passos

V. M.

Champs

A. P. S.

Teixeira

Lima-Costa

M. F. F.

Kirkwood

Veras

Nascimento

B. R.

Nogales

A. M.

Schmidt

M. I.

Duncan

B. B.

Cousin

Naghavi

Souza

F. M.

(2020). The burden of disease among Brazilian older adults and the challenge for health policies: Results of the Global Burden of Disease Study 2017. Population Health Metrics, 18(S1), 14. https://doi.org/10.1186/s12963-020-00206-3

16.

de Souza Moreira

de Souza Andrade

A. C.

Lustosa Torres

de Souza Braga

de Carvalho Bastone

de Melo Mambrini

J. V.

Lima-Costa

M. F.

(2022). Nationwide handgrip strength values and factors associated with muscle weakness in older adults: Findings from the Brazilian longitudinal Study of Aging (ELSI-Brazil). BMC Geriatrics, 22(1), 1005. https://doi.org/10.1186/s12877-022-03721-0

17.

Eeles

Low Choy

(2015). Frailty and mobility. In Theou Olga Rockwood

Kenneth

(Eds.), Frailty in aging : Biological, clinical and social implications (pp. 107–120).

18.

Eeles

E. M. P.

White

S. V.

O’mahony

S. M.

Bayer

A. J.

Hubbard

R. E.

(2012). The impact of frailty and delirium on mortality in older inpatients. Age and Ageing, 41(3), 412–416. https://doi.org/10.1093/ageing/afs021

19.

Faber

M. J.

Bosscher

R. J.

Chin A Paw

M. J.

van Wieringen

P. C.

(2006). Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 87(7), 885–896. https://doi.org/10.1016/j.apmr.2006.04.005

20.

Freitas

J. L. G. d. S.

Silva

J. M. M.

Nóbrega

J. C. L.

Simões

R. F. M.

Medeiros

J. B.

Alves

R. O.

Santos

J. L. F.

Duarte

Y. A. O.

Zatz

Matheson

Menezes

T. N.

Santos

(2022). Health-related quality of life and associated factors: Regional differences among oldest-old in Brazil. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 59, 469580221086922. https://doi.org/10.1177/00469580221086922

21.

Fried

L. P.

Tangen

C. M.

Walston

Newman

A. B.

Hirsch

Gottdiener

Seeman

Tracy

Kop

W. J.

Burke

McBurnie

M. A.

Cardiovascular Health Study Collaborative Research Group . (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(3), M146–M157. https://doi.org/10.1093/gerona/56.3.m146

22.

Gobbi

Sebastião

Papini

C. B.

Nakamura

P. M.

Valdanha Netto

Gobbi

L. T. B.

Kokubun

(2012). Physical inactivity and related barriers: A study in a community dwelling of older Brazilians. Journal of Aging Research, 2012, 685190. https://doi.org/10.1155/2012/685190

23.

Gomes

I. C.

Oliveira Neto

Tavares

V. D. O.

Duarte

Y. A. O.

(2022). Association between low level of physical activity and mobility limitation in older adults: Evidence from the SABE study. Ciencia & Saude Coletiva, 27(3), 1171–1180. https://doi.org/10.1590/1413-81232022273.02402021

24.

Hoogendijk

E. O.

Afilalo

Ensrud

K. E.

Kowal

Onder

Fried

L. P.

(2019). Frailty: Implications for clinical practice and public health. Lancet (London, England), 394(10206), 1365–1375. https://doi.org/10.1016/S0140-6736(19)31786-6

25.

Howlett

S. E.

Rutenberg

A. D.

Rockwood

(2021). The degree of frailty as a translational measure of health in aging. Nature Aging, 1(8), 651–665. https://doi.org/10.1038/s43587-021-00099-3

26.

IPEA - Instituto de Pesquisa Econômica Aplica . (2018). População idosa brasileira deve aumentar até 2060. Available from. https://portalantigo.ipea.gov.br/agencia/index.php?option=com_content&view=article&id=33875

27.

Jacobs

J. M.

Cohen

Ein-Mor

Maaravi

Stessman

(2011). Frailty, cognitive impairment and mortality among the oldest old. The Journal of Nutrition, Health & Aging, 15(8), 678–682. https://doi.org/10.1007/s12603-011-0096-3

28.

Källberg

A. S.

Berg

L. M.

Skogli

Bjurbo

Muntlin

Å.

Ehrenberg

(2023). Prevalence of frailty and associated factors in older adults seeking care at Swedish emergency departments. BMC Geriatrics, 23(1), 798. https://doi.org/10.1186/s12877-023-04545-2

29.

Keadle

S. K.

McKinnon

Graubard

B. I.

Troiano

R. P.

(2016). Prevalence and trends in physical activity among older adults in the United States: A comparison across three national surveys. Preventive Medicine, 89, 37–43. https://doi.org/10.1016/j.ypmed.2016.05.009

30.

Kehler

D. S.

Theou

(2019). The impact of physical activity and sedentary behaviors on frailty levels. Mechanisms of Ageing and Development, 180, 29–41. https://doi.org/10.1016/j.mad.2019.03.004

31.

Lewis

Heymann

Zacay

Justo

(2024). Frailty and its association with long-term mortality among community-dwelling older adults aged 75 years and over. Israel Journal of Health Policy Research, 13(1), 26. https://doi.org/10.1186/s13584-024-00614-y

32.

Schöttker

Holleczek

Brenner

(2022). Association of longitudinal repeated measurements of frailty index with mortality: Cohort study among community-dwelling older adults. EClinicalMedicine, 53, 101630. https://doi.org/10.1016/j.eclinm.2022.101630

33.

Lima-Costa

M. F.

de Andrade

F. B.

Souza

P. R. B.

Neri

A. L.

Duarte

Y. A. O.

Castro-Costa

de Oliveira

(2018). The Brazilian longitudinal study of aging (ELSI-Brazil): Objectives and design. American Journal of Epidemiology, 187(7), 1345–1353. https://doi.org/10.1093/aje/kwx387

34.

Lima-Costa

M. F.

de Melo Mambrini

J. V.

Andrade

Souza

P. R. B.

de Vasconcellos

M. T. L.

Neri

A. L.

Castro-Costa

Macinko

de Oliveira

(2023). Cohort profile: The Brazilian longitudinal study of ageing (ELSI-Brazil). International Journal of Epidemiology, 52(1), e57–e65. https://doi.org/10.1093/ije/dyac132

35.

Lima-Costa

M. F.

De Oliveira

Macinko

Marmot

(2012). Socioeconomic inequalities in health in older adults in Brazil and England. American Journal of Public Health, 102(8), 1535–1541. https://doi.org/10.2105/AJPH.2012.300765

36.

Lin

J.-W.

Lin

P.-Y.

Wang

T.-Y.

Chen

Y.-J.

Yen

Huang

H.-H.

(2024). The association between frailty evaluated by clinical frailty scale and mortality of older patients in the emergency department: A prospective cohort study. Clinical Interventions in Aging, 19, 1383–1392. https://doi.org/10.2147/CIA.S472991

37.

Mathews

(2024). Population ageing in Lower- and middle-income countries. Celebrating 40 years of HelpAge international. Journal of Population Ageing, 17(1), 1–4. https://doi.org/10.1007/s12062-024-09447-8

38.

Moreira

B. S.

Andrade

A. C. S.

Bastone

A. C.

Torres

J. L.

Braga

L. S.

Ygnatios

N. T. M.

Mambrini

J. V. M.

Lima-Costa

M. F.

Kirkwood

R. N.

(2023). Home-based gait speed and the association with sociodemographic and anthropometric variables: A national study (ELSI-Brazil). Geriatric Nursing, 51, 400–407. https://doi.org/10.1016/j.gerinurse.2023.04.001

39.

Nuesse

Lemke

Holube

(2024). Associations of frailty, self-reported balance problems, hearing abilities, and posturography in a sample of older adults. International Journal of Audiology, 64(5), 509–517. https://doi.org/10.1080/14992027.2024.2383985

40.

O’Caoimh

Sezgin

O’Donovan

M. R.

Molloy

D. W.

Clegg

Rockwood

Liew

(2021). Prevalence of frailty in 62 countries across the world: A systematic review and meta-analysis of population-level studies. Age and Ageing, 50(1), 96–104. https://doi.org/10.1093/ageing/afaa219

41.

Ofori-Asenso

Chin

K. L.

Mazidi

Zomer

Ilomaki

Zullo

A. R.

Gasevic

Ademi

Korhonen

M. J.

LoGiudice

Bell

J. S.

Liew

(2019). Global incidence of frailty and prefrailty among community-dwelling older adults. JAMA Network Open, 2(8), Article e198398. https://doi.org/10.1001/jamanetworkopen.2019.8398

42.

Pérez

R. A.

Tejada

C. A. O.

Triaca

L. M.

Bertoldi

A. D.

dos Santos

A. M. A.

(2022). Socioeconomic inequality in health in older adults in Brazil. Dialogues in Health, 1, 100009. https://doi.org/10.1016/j.dialog.2022.100009

43.

Salive

M. E.

(2013). Multimorbidity in older adults. Epidemiologic Reviews, 35(1), 75–83. https://doi.org/10.1093/epirev/mxs009

44.

Schwartz

R. S.

Evans

W. J.

(1995). Effects of exercise on body composition and functional capacity of the elderly. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 50A(Special), 147–150. https://doi.org/10.1093/gerona/50a.special_issue.147

45.

Schwenk

Mohler

Wendel

D’Huyvetter

Fain

Taylor-Piliae

Najafi

(2015). Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: Baseline results of the Arizona frailty cohort study. Gerontology, 61(3), 258–267. https://doi.org/10.1159/000369095

46.

Travassos

G. F.

Coelho

A. B.

Arends-Kuenning

M. P.

(2020). The elderly in Brazil: Demographic transition, profile, and socioeconomic condition. Revista Brasileira de Estudos de Populacao, 37, 1–27. https://doi.org/10.20947/S0102-3098a0129

47.

VanItallie

T. B.

(2003). Frailty in the elderly: Contributions of sarcopenia and visceral protein depletion. Metabolism: Clinical and Experimental, 52(10 Suppl 2), 22–26. https://doi.org/10.1016/s0026-0495(03)00297-x

48.

van Poppel

M. N. M.

Chinapaw

M. J. M.

Mokkink

L. B.

van Mechelen

Terwee

C. B.

(2010). Physical activity questionnaires for adults. Sports Medicine, 40(7), 565–600. https://doi.org/10.2165/11531930-000000000-00000

49.

Walsh

Fogg

Harris

Roderick

de Lusignan

England

Clegg

Brailsford

Fraser

S. D. S.

(2023). Frailty transitions and prevalence in an ageing population: Longitudinal analysis of primary care data from an open cohort of adults aged 50 and over in England, 2006–2017. Age and Ageing, 52(5), afad058. https://doi.org/10.1093/ageing/afad058

50.

Watson

K. B.

Carlson

S. A.

Gunn

J. P.

Galuska

D. A.

O’Connor

Greenlund

K. J.

Fulton

J. E.

(2016). Physical inactivity among adults aged 50 years and older — United States, 2014. MMWR. Morbidity and Mortality Weekly Report, 65(36), 954–958. https://doi.org/10.15585/mmwr.mm6536a3

51.

WHO . (2020). WHO guidelines on physical activity and sedentary behaviour. World Health Organization.

52.

(2022). The risk of falls among the aging population: A systematic review and meta-analysis. Frontiers in Public Health, 10, 902599.

53.

Zeng

Feng

Hesketh

Christensen

Vaupel

J. W.

(2017). Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: A cohort study. Lancet (London, England), 389(10079), 1619–1629. https://doi.org/10.1016/S0140-6736(17)30548-2

54.

Zhang

Englund

D. A.

Aversa

Jachim

S. K.

White

T. A.

LeBrasseur

N. K.

(2022). Exercise counters the age-related accumulation of senescent cells. Exercise and Sport Sciences Reviews, 50(4), 213–221. https://doi.org/10.1249/JES.0000000000000302

55.

Zhu

Ping

Zhang

Ning

Zhao

Yao

(2022). Sex hormones and physical function among the Chinese oldest-old and Centenarian women. Journal of Translational Medicine, 20(1), 340. https://doi.org/10.1186/s12967-022-03539-9

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