Meeting the 24-Hour Movement Guidelines and Frailty Risk: Evidence From Two Nationally Representative Population...

Area of Science:

• Gerontology and Public Health
• Epidemiology
• Behavioral Science

Background:

• Frailty is a significant geriatric syndrome associated with adverse health outcomes.
• The 24-Hour Movement Guidelines integrate physical activity, sleep, and sedentary behavior, but their combined impact on frailty is not well-established.

Purpose of the Study:

• To investigate the association between adherence to the 24-Hour Movement Guideline components and frailty in two large, nationally representative populations.
• To explore the relationship using both cross-sectional and longitudinal designs, complemented by machine learning techniques.

Main Methods:

• Analysis of 11,893 NHANES participants (2011-2018) and 4,823 CHARLS participants (2011-2018).
• Cross-sectional analysis using multivariable logistic regression and longitudinal analysis using Cox proportional hazards models.
• Exploratory machine learning (Random Forest, SHAP) for frailty classification and feature importance.

Main Results:

• Meeting all three 24-Hour Movement Guideline components was significantly associated with lower odds of frailty in both NHANES (OR=0.21) and CHARLS (OR=0.29).
• Adherence to two-component combinations also showed reduced frailty odds.
• Longitudinal analysis in CHARLS revealed a lower hazard of incident frailty (HR=0.33) for those meeting all three components compared to none.

Conclusions:

• Adherence to multiple components of the 24-Hour Movement Guidelines is associated with reduced frailty prevalence and incidence.
• These findings underscore the importance of viewing movement behaviors holistically within a 24-hour framework for mitigating frailty risk.