Table 3.
Summary of overall effects and subgroup analysis results for frailty indices.
| Subgroup | Global Frailty Score a | Whole Body Mass | Handgrip Strength | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Comparison, n (LoE) b | SMD | (95%CI) | p Value | I2 (%) | Comparison, n (LoE)b | SMD | (95%CI) | p Value | I2 (%) | Comparison, n (LoE)b | SMD | (95%CI) | p Value | I2 (%) | |
| Overall | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 11 (S) | 0.38 | (0.23, 0.52) † | <0.00001 | 37 | 15 (S) | 0.17 | (0.05, 0.30) † | 0.006 | 26 |
| MQ level (PEDro score) | |||||||||||||||
| ≥7/10 | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 6 (M) | 0.58 | (0.24, 0.92) ‡ | 0.0009 | 65 | 7 (S) | 0.31 | (0.11, 0.50) † | 0.002 | 50 |
| <7/10 | 0 | 5 (M) | 0.24 | (0.02, 0.46) † | 0.03 | 0 | 8 (C) | 0.08 | (0.08, 0.24) † | n.s. | 0 | ||||
| Subgroup difference | NA | NA | n.s. | 62.3 | n.s. | 54 | |||||||||
| Participant type | |||||||||||||||
| Community dweller | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 6 (M) | 0.58 | (0.25, 0.91) ‡ | 0.0006 | 65 | 7 (S) | 0.18 | (0.01, 0.36) † | 0.04 | 24 |
| Institutionalized resident | 0 | 5 (C) | 0.22 | (−0.02, 0.45) † | n.s. | 0 | 8 (C) | 0.17 | (−0.01, 0.34) † | n.s. | 37 | ||||
| Subgroup difference | NA | NA | n.s. | 66.5 | n.s. | 0 | |||||||||
| Population area | |||||||||||||||
| Americas | 0 | 1 (C) | 0.41 | (−0.06, 0.88) | n.s. | NA | 2 (C) | 0.46 | (−0.45, 1.37) ‡ | n.s. | 85 | ||||
| Asia | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 1 (M) | 0.66 | (0.26, 1.06) | 0.001 | NA | 4 (C) | 0.05 | (−0.19, 0.29) † | n.s. | 31 |
| Europe | 0 | 9 (S) | 0.33 | (0.16, 0.49) † | 0.0001 | 41 | 8 (S) | 0.24 | (0.06, 0.42) † | 0.007 | 0 | ||||
| Oceania | 0 | 0 | 1 (C) | −0.05 | (−0.52, 0.43) | n.s. | NA | ||||||||
| Subgroup difference | NA | NA | n.s. | 0 | n.s. | 0 | |||||||||
| Control group type | |||||||||||||||
| PLA-S or nonexercise | 1 (M) | 1.08 | (0.56, 1.60) | <0.0001 | NA | 7 (S) | 0.43 | (0.22, 0.64) † | <0.0001 | 38 | 9 (S) | 0.09 | (−0.09, 0.26) † | n.s. | 15 |
| Exercise | 1 (C) | 0.34 | (−0.14, 0.83) | n.s. | NA | 8 (S) | 0.32 | (0.14, 0.50) † | 0.0005 | 26 | 11 (S) | 0.28 | (0.12, 0.43) † | 0.0007 | 29 |
| PS | 1 (M) | 0.63 | (0.13, 1.13) | 0.01 | NA | 4 (S) | 0.37 | (0.11, 0.63) † | 0.006 | 56 | 2 (L) | 0.16 | (−0.22, 0.54) † | n.s. | 74 |
| Subgroup difference | n.s. | 52.1 | n.s. | 0 | n.s. | 4.7 | |||||||||
| Supplementation dose | |||||||||||||||
| ≥30 g/day (g/session) | 4 (S) | 0.65 | (0.36, 0.92 )† | <0.00001 | 35 | 5 (S) | 0.28 | (0.04, 0.51) † | 0.02 | 10 | |||||
| <30 g/day (g/session) | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 7 (S) | 0.26 | (0.07, 0.46) † | 0.001 | 9 | 10 (C) | 0.13 | (−0.01, 0.28) † | n.s. | 34 |
| Subgroup difference | NA | NA | 0.03 | 78.2 | n.s. | 0 | |||||||||
| Exercise type | |||||||||||||||
| RET | 0 | 4 (M) | 0.44 | (0.03, 0.84) ‡ | 0.04 | 63 | 6 (S) | 0.26 | (0.07, 0.46) † | 0.008 | 0 | ||||
| MET | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 7 (S) | 0.38 | (0.19, 0.56) † | <0.0001 | 21 | 9 (C) | 0.11 | (−0.05, 0.28) † | n.s. | 39 |
| Subgroup difference | NA | NA | n.s. | 0 | n.s. | 0 | |||||||||
| Intervention duration | |||||||||||||||
| <12 weeks | 0 | 5 (C) | 0.19 | (−0.04, 0.42) † | n.s. | 0 | 4 (C) | 0.29 | (−0.14, 0.72) ‡ | n.s. | 59 | ||||
| 12–24 weeks | 1 (M) | 0.62 | (0.21, 1.03) | 0.003 | NA | 7 (S) | 0.38 | (0.20, 0.57) † | <0.0001 | 19 | 11 (C) | 0.09 | (−0.05, 0.23) † | n.s. | 0 |
| ≥24 weeks | 0 | 4 (C) | 0.43 | (−0.02, 0.87) ‡ | 0.04 | 64 | 6 (S) | 0.23 | (0.04, 0.43) † | 0.02 | 0 | ||||
| Subgroup difference | NA | NA | n.s. | 0 | n.s. | 0 | |||||||||
| Overall | 14 (M) | 0.32 | (0.05, 0.59) ‡ | 0.02 | 75 | 2 (M) | 0.68 | (0.35, 1.02) † | <0.0001 | 0 | 6 (C) | 0.16 | (−0.22, 0.54) ‡ | n.s. | 76 |
| MQ level (PEDro score) | |||||||||||||||
| ≥7/10 | 10 (M) | 0.48 | (0.19, 0.77) ‡ | 0.001 | 67 | 2 (M) | 0.68 | (0.35, 1.02) † | <0.0001 | 0 | 4 (C) | 0.23 | (−0.35, 0.82) ‡ | n.s. | 83 |
| <7/10 | 4 (C) | 0.05 | (−0.54, 0.63) ‡ | n.s. | 82 | 0 | 2 (C) | 0.02 | (−0.30, 0.27) † | n.s. | 0 | ||||
| Subgroup difference | n.s. | 41.3 | NA | NA | n.s. | 0 | |||||||||
| Participant type | |||||||||||||||
| Community dweller | 8 (C) | 0.32 | (−0.08, 0.73) ‡ | n.s. | 80 | 0 | 4 (C) | 0.21 | (−0.38, 0.80) ‡ | n.s. | 85 | ||||
| Institutionalized resident | 6 (C) | 0.31 | (−0.03, 0.65) ‡ | n.s. | 65 | 2 (M) | 0.68 | (0.35, 1.02) † | <0.0001 | 52 | 2 (C) | 0.05 | (−0.28, 0.37) † | n.s. | 0 |
| Subgroup difference | n.s. | 0 | NA | NA | n.s. | 0 | |||||||||
| Population area | |||||||||||||||
| Americas | 3 (C) | 0.22 | (−0.36, 0.80) ‡ | n.s. | 79 | 0 | 2 (C) | −0.10 | 6(−0.38, 0.19) † | n.s. | 0 | ||||
| Asia | 1 (M) | 1.39 | (0.96, 1.82) | <0.0001 | NA | 0 | 9 (C) | 0.33 | (−0.43, 1.09) ‡ | n.s. | 86 | ||||
| Europe | 9 (S) | 0.17 | (0.01, 0.33) † | 0.04 | 0 | 2 (M) | 0.68 | (0.35, 1.02)† | <0.0001 | 52 | 1 (C) | 0.16 | (−0.31, 0.63) | n.s. | NA |
| Oceania | 1 (L) | 0.92 | (0.42, 1.42) | 0.0003 | NA | 0 | 0 | ||||||||
| Subgroup difference | <0.00001 | 90.5 | NA | NA | n.s. | 0 | |||||||||
| Control group type | |||||||||||||||
| PLA-S or nonexercise | 8 (M) | 0.38 | (0.21, 0.55) ‡ | <0.0001 | 77 | 0 | 4 (C) | 0.37 | (−0.15, 0.89)‡ | n.s. | 78 | ||||
| Exercise | 11 (C) | 0.16 | (−0.01, 0.33) † | n.s. | 0 | 2 (M) | 0.68 | (0.35, 1.02) † | <0.0001 | 52 | 5 (C) | 0.10 | (−0.51, 0.71) ‡ | n.s. | 84 |
| PS | 3 (S) | 0.44 | (0.16, 0.72) † | 0.002 | 60 | 0 | 2 (C) | 0.59 | (−0.27, 1.46) ‡ | n.s. | 80 | ||||
| Subgroup difference | n.s. | 40.5 | NA | NA | n.s. | 0 | |||||||||
| Supplementation dose | |||||||||||||||
| ≥30 g/day (g/session) | 8 (S) | 0.26 | (0.07, 0.45) † | 0.007 | 46 | 0 | 2 (C) | 0.05 | (−0.28, 0.37) † | n.s. | 0 | ||||
| <30 g/day (g/session) | 6 (C) | 0.39 | (−0.13, 0.91) ‡ | n.s. | 87 | 2 (M) | 0.68 | (0.35, 1.02) † | <0.0001 | 52 | 4 (M) | 0.21 | (−0.38, 0.80) ‡ | n.s. | 85 |
| Subgroup difference | n.s. | 0 | NA | NA | n.s. | 0 | |||||||||
| Exercise type | |||||||||||||||
| RET | 6 (C) | 0.31 | (−0.02, 0.64) ‡ | n.s. | 58 | 1 (L) | 0.67 | (0.30, 1.04) | 0.0003 | NA | 2 (C) | 0.05 | (−0.28, 0.37)† | n.s. | 0 |
| MET | 8 (C) | 0.32 | (−0.09, 0.73) ‡ | n.s. | 82 | 1 (C) | 0.75 | (−0.09, 1.58) | n.s. | NA | 4 (C) | 0.21 | (−0.38, 0.80)‡ | n.s. | 85 |
| Subgroup difference | n.s. | 0 | n.s. | 0 | n.s. | 0 | |||||||||
| Intervention duration | |||||||||||||||
| <12 weeks | 6 (S) | 0.32 | (0.11, 0.53) † | 0.003 | 0 | 1 (L) | 0.67 | (0.30, 1.04) | 0.0003 | NA | 1 (C) | −0.06 | (−0.51, 0.40)‡ | n.s. | NA |
| 12–24 weeks | 8 (M) | 0.53 | (0.09, 0.97) ‡ | 0.02 | 83 | 1 (C) | 0.75 | (−0.09, 1.58) | n.s. | NA | 3 (C) | 0.33 | (−0.43, 1.09)‡ | n.s. | 86 |
| ≥24 weeks | 6 (C) | −0.08 | (−0.28, 0.12) † | n.s. | 0 | 0 | 2 (C) | −0.02 | (−0.30, 0.27)† | n.s. | 0 | ||||
| Subgroup difference | 0.006 | 80.8 | n.s. | 0 | n.s. | 48.7 | |||||||||
† Fixed-effects model. ‡ Random-effects model. a Global frailty score is defined as a number out of five frailty components of Fried’s criteria [24]. b f evidence: strong (S), moderate (M), limited (L), conflicting (C). LoE, level of evidence; SMD, standard mean difference; I2, heterogeneity; MQ, methodological quality; PEDro, Physiotherapy Evidence Database; n.s., nonsignificant (p > 0.05); PLA-S, placebo supplement; PS, protein supplementation; RET, resistance exercise training; MET, multicomponent exercise training; NA, not applicable.