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Domain-Specific Physical Activity and Its Association With Frailty Syndrome: Evidence From NHANES Using Phenotype and

Fujue Ji1,2,3, Jiao Liu1,3, Jiaxuan Chen1

  • 1Department of Physical Education, College of Performing Arts and Sport, Hanyang University, Seoul, Republic of Korea.

Geriatrics & Gerontology International
|February 4, 2026
PubMed
Summary

Leisure-time physical activity (LTPA) significantly reduces frailty syndrome. Engaging in LTPA, especially for 300 minutes weekly, is key for healthy aging and preventing frailty.

Keywords:
NHANESfrailty indexfrailty phenotypefrailty syndromephysical activity

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Area of Science:

  • Gerontology
  • Public Health
  • Exercise Science

Background:

  • Frailty syndrome is a prevalent age-related condition linked to adverse health outcomes.
  • Physical activity (PA) is a modifiable factor, but its specific domains' impact on frailty needs further investigation.
  • Validated multidimensional frailty models are crucial for accurate assessment.

Purpose of the Study:

  • To investigate the associations between four PA domains (total PA, occupational PA (OPA), transport-related PA (TPA), and leisure-time PA (LTPA)) and frailty.
  • To assess frailty using both the frailty phenotype (FP) and frailty index (FI) models.
  • To analyze these associations in a nationally representative U.S. adult population.

Main Methods:

  • Analysis of 59,842 adults from NHANES (2007-2018) data.
  • PA levels categorized by weekly duration and guideline adherence (≥150 min/week).
  • Frailty assessed independently using FP and FI models; multivariable regression, subgroup, sensitivity, and dose-response analyses performed.

Main Results:

  • Higher total PA and LTPA consistently correlated with lower frailty scores (FP and FI models).
  • LTPA ≥300 min/week showed the strongest inverse association with frailty.
  • OPA and TPA had limited/no association; effects were pronounced in older adults (≥80 years) and women.

Conclusions:

  • Leisure-time physical activity (LTPA) is strongly associated with reduced frailty.
  • LTPA emerges as a critical target for preventive strategies and public health guidelines.
  • Promoting LTPA can contribute significantly to healthy aging initiatives.