BACKGROUND: Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S. METHODS: This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2-3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up. RESULTS: Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3-7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41-0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23-0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34-0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18-0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group. CONCLUSIONS: In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance. TRIAL REGISTRATION: ClinicalTrials.gov NCT02582138.

Biomedical Research Center Network for Frailty and Healthy Ageing Institute of Health Carlos 3 Madrid Spain

Center for Life Course Health Research University of Oulu Oulu Finland

CHU Limoges Department of Geriatric Medicine UR 24134 VieSante Research Unit Limoges France

Cognitive and Motor Centre Medicine and Geriatric Rehabilitation Department of Parma University Hospital of Parma Parma Italy

Department of Cardiology and Pneumology University Göttingen Medical Center Göttingen Germany

Department of Clinical and Molecular Sciences Università Politecnica delle Marche Ancona Italy

Department of Clinical Sciences and Community Health University of Milan Milan Italy

Department of Geriatrics 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czech Republic

Department of Geriatrics Hospital Universitario de Getafe Madrid Spain

Department of Geriatrics Landspitali University Hospital Faculty of Medicine University of Iceland Reykjavik Iceland

Department of Geriatrics Orthopaedics and Rheumatology Università Cattolica del Sacro Cuore Rome Italy

Department of Internal Medicine and Gerontology Faculty of Medicine Uniwersytet Jagiellonski Collegium Medicum Krakow Poland

Department of Internal Medicine Medical University of Graz Graz Austria

Department of Medicine and Surgery Università degli Studi di Parma Parma Italy

Department of Respiratory Medicine Research Institute NUTRIM Maastricht University Medical Centre Maastricht The Netherlands

DROP and King's College London UK

DZHK Partner Site Lower Saxony Göttingen Germany

Faculty of Health and Social Sciences University of South Bohemia Ceske Budejovice Czech Republic

Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy

Geriatria Accettazione Geriatrica e Centro di Ricerca per l'Invecchiamento IRCCS INRCA Ancona Italy

Gérontopôle Centre Hospitalier Universitaire de Toulouse Toulouse France

Helsinki University and Helsinki University Hospital Helsinki Finland

IHU HealthAge CHU University of Toulouse INSERM CERPOP Toulouse France

Institute for Biomedicine of Aging Friedrich Alexander Universität Erlangen Nürnberg Nurnberg Germany

Instituto de Investigación IdiPaz Madrid Spain

Servicio de Geriatría Hospital Universitario Ramón y Cajal IRYCIS Madrid Spain

Silesian Hospital in Opava Opava Czech Republic

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ClinicalTrials.gov
NCT02582138