Research Paper Volume 12, Issue 1 pp 288—308

Associations of lifestyle activities and a heathy diet with frailty in old age: a community-based study in Singapore

Xiu Wang1, , Yanxia Lu2,3, , Chunbo Li4,5, , Anis Larbi3, , Liang Feng6, , Qingfeng Shen7, , Mei Sian Chong8, , Wee Shiong Lim9, , Lei Feng10,11, ,

  • 1 Department of Neurology, Beijing Chuiyangliu Hospital, Beijing, PR China
  • 2 Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
  • 3 Biology of Ageing Laboratory, Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Singapore
  • 4 Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
  • 5 Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
  • 6 Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
  • 7 Department of Geriatric Psychiatry, Xuzhou Oriental people’s Hospital, China
  • 8 Geriatric Education and Research Institute, Singapore
  • 9 Department of Geriatric Medicine, Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
  • 10 Department of Psychological Medicine, National University of Singapore, Singapore
  • 11 Centre for Healthy Ageing, National University Health System, Singapore

Received: August 20, 2019       Accepted: December 5, 2019       Published: January 2, 2020
How to Cite

Copyright: © 2020 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Frailty is an age-related state characterized by a reduced physiological reserve, and is associated with adverse health outcomes in the elderly. We analyzed the data from 895 adults aged 60 years and above, and investigated the relationships between midlife and late-life social activities, intellectual activities, working hours, and dietary habits and frailty status. Participation in social or intellectual activities in late life was less prevalent among those who were frail than among those who were robust. A greater proportion of those who were frail had worked long hours in midlife. After adjustment for confounders, participating in social activities or intellectual activities in late life was associated with a reduced risk for prefrailty and frailty, while working long hours in midlife was associated with a higher risk for frailty. The risk of frailty decreased with increasing healthy diet scores in midlife and late life. When the results were stratified by gender, late-life participation in social activities and midlife or late-life participation in intellectual activities correlated negatively with prefrailty/frailty only in women. Our study suggests that social and intellectual activities are inversely associated with frailty status, but the association seems to differ based on gender.


HDS: healthy diet score; OR: odds ratio; Cl: 95% confidence intervals; SD: standard deviation; GAI: Geriatric Anxiety Inventory; SM-MMSE: Singapore Modified Mini-Mental State Examination; COPD: Chronic Obstructive Pulmonary disease; GIP: Gastrointestinal problems; DaHA: Diet and Healthy Aging Study.