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This systematic review and dose-response meta-analysis examined the effects of aerobic exercise on frailty and related health outcomes in older adults aged 60 and over who were classified as frail or pre-frail. Researchers analysed forty-four randomised controlled trials involving over four thousand participants, standardising varied exercise protocols to allow meaningful comparison across studies.
The results showed that aerobic exercise produced statistically significant improvements across multiple outcomes compared with usual care. These included reductions in frailty severity and depressive symptoms, as well as gains in muscle strength, cognitive function, quality of life, and lower-limb functional performance. Subgroup analyses found that different aerobic exercise modalities — including Tai Chi, dance, and walking — were all effective, with no single type proving superior to the others.
Regarding dose, the findings suggest that initiating exercise at low-to-moderate volumes is beneficial and achievable for this population. However, the authors caution that considerable variation between studies and limited data at higher exercise doses mean that a definitive optimal prescription cannot yet be established. They recommend that exercise programmes be tailored to each individual’s tolerance, preferences, and clinical circumstances.
Conclusion: Aerobic exercise, including Tai Chi, appears to be an effective and accessible intervention for improving frailty status and a range of functional and psychological health outcomes in older adults, though individualised prescriptions are advised given current evidence limitations.
Source: Luo H, Zheng Z, Sun M and colleagues. Clinical nutrition (Edinburgh, Scotland) (2026). View on PubMed (PMID 42617397) · doi:10.1016/j.clnu.2026.106748
