Could exercise be linked to better health even in frailer older adults?

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There has been concern that preventive measures for older people might increase frailty by extending survival without improving health. Researchers investigated exercise in relation to the chances of health improvement, deterioration and death among community-dwelling older adults.

In the Canadian Study of Health and Aging, health was measured using a frailty index based on the number of health deficits. Exercise was classified as high or low/no exercise using a validated, self-administered questionnaire. Health status and survival were reassessed after 5 years. Of 6,297 eligible participants, 5,555 had complete data.

Across all frailty levels, men and women over 75 who exercised had death rates similar to those of their peers aged 65 to 75 who did not exercise. Exercisers had a greater chance of improving their health, with the greatest benefits observed among those who were more frail. Among participants with 2 health deficits at baseline, health improved or remained stable in 34% of high exercisers versus 26% of low/no exercisers. Among those with 9 deficits at baseline, the corresponding figures were 40% versus 22%.

The researchers concluded that exercise attenuated the impact of age on mortality across all frailty levels. They also concluded that its greatest benefits for health improvement were among those more frail at baseline, and that its net effect should be to improve health at the population level.