A decline in physical activity (PA) levels have been observed in pre-frail older adults and are associated with progression to frailty.  People with COPD are at risk for frailty, however, PA levels in pre-frail patients with COPD are unknown. This study described and compared PA levels and sedentary behaviour (SB) between non-frail and pre-frail patients with COPD. 

Frailty was determined based on the 5 criteria of Fried?s frailty phenotype: low grip strength (Jamar dynamometer), unintentional weight loss (self-report), slow walking speed (4.57m course), exhaustion (2 questions from the Center for Epidemiological Studies Depression scale) and low PA (cut-off points of weekly energy expenditure from accelerometry) ( ?3 criteria ? frail; 1-2 criteria ? pre-frail; 0 ? non-frail). Daily PA was assessed using accelerometry (7 days): steps/day; time in moderate and vigorous PA (MVPA), total PA (TPA ? light PA+MVPA) and SB. Mann-Whitney-U tests were used to compare PA and SB between groups. 

Forty-three pre-frail (67±8 years, 81% male, FEV1pp 43±18, BMI 26±6) and 39 non-frail (68±8 years, 72% male, FEV1pp 58±17, BMI 26±4) patients were included. Exhaustion was the most prevalent factor in pre-frail patients (72%). Pre-frail patients spent less time in MVPA (median [Q1; Q3] 15[6;31] min/day vs 30[14;55], p=0.012); TPA (107[85;193] min/day vs 152[134;212] min/day, p=0.029) and presented lower steps/day (3566 [2289;5683] vs 5894 [3434;7909] steps/day, p=0.006) than non-frail patients. No differences were found in SB (p=0.605).

PA levels are reduced in pre-frail when compared to non-frail patients with COPD. Future studies should explore if increasing PA in PF patients reduces their risk for frailty.