title: Leisure-time physical activity in midlife is related to old age frailty.
abstract: BACKGROUND
  There are scarce studies of the long-term associations between leisure-time physical activity (LTPA) in midlife and phenotypic frailty in old age.
  
  
  METHODS
  We studied healthy Caucasian men of high socioeconomic status (N = 514), who had participated in health checkups during the 1960s (the Helsinki Businessmen Study, Finland). In 1974, they were examined with questionnaires and clinical examinations, and LTPA was collapsed into three categories: low (n = 87), moderate (n = 256), and high (n = 171). In 2000, at mean age of 74, survivors were assessed for physical activity and frailty phenotype using the modified Fried criteria validated in our cohort. Four criteria were used: (a) weight loss > 5% from midlife or current body mass index < 21kg/m(2), (b) physical inactivity, (c) low vitality, and (d) physical weakness. Responders with 3-4, 1-2, and zero criteria were classified as frail, prefrail, and nonfrail, respectively.
  
  
  RESULTS
  The prevalence of frailty was 16.1%, 10.2%, and 4.7% in the low, moderate, and high LTPA groups, respectively. Higher midlife LTPA was significantly related to lower prevalence of both frailty and prefrailty in old age. After adjusting for baseline age, smoking, body mass index, blood pressure, and alcohol, the risk of frailty was 80% lower in the high LTPA group compared with the low LTPA group (odds ratio = 0.20; 95% confidence interval 0.07-0.55). This finding was supported by the relationships between the change of physical activity and frailty in old age.
  
  
  CONCLUSIONS
  In this socioeconomically homogenous male cohort, higher physical activity since midlife was strongly associated with less frailty in old age.
authors.affiliation: Institute of Health Sciences/Geriatrics, University of Oulu and University Hospital, PO Box 5000, 90014 Oulu, Finland. timo.strandberg@oulu.fi.
authors.forename: Salla L
authors.initials: SL
authors.lastname: Savela
authors.forename: Pentti
authors.initials: P
authors.lastname: Koistinen
authors.forename: Sari
authors.initials: S
authors.lastname: Stenholm
authors.forename: Reijo S
authors.initials: RS
authors.lastname: Tilvis
authors.forename: Arto Y
authors.initials: AY
authors.lastname: Strandberg
authors.forename: Kaisu H
authors.initials: KH
authors.lastname: Pitkälä
authors.forename: Veikko V
authors.initials: VV
authors.lastname: Salomaa
authors.forename: Timo E
authors.initials: TE
authors.lastname: Strandberg
mesh_terms: D000368:Aged; D015444:Exercise; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged
keywords: Frailty; Physical activity; Preventative health care; Successful aging.