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Background: Physical frailty accelerates the timing of both subsequent disability and death; however, evidence regarding the impact of frailty on the period from disability onset to death and sex differences of this impact is lacking. The aim of this study was to examine the relationship among physical frailty, disability, death, and sex differences. Methods: This Japanese cohort study included 10,524 community‐dwelling people aged ≥65 years. Physical frailty was operationalized by key phenotypes as per Fried's criteria (slowness, weakness, exhaustion, weight loss, and low activity) at baseline. We calculated hazard ratios (HRs) with 95% confidence intervals (CIs) for disability onset and post‐disability survival according to the frailty status. Results: During a 5‐year follow‐up, the risk of disability onset for pre‐frailty (HR: 1.74, 95% CI: 1.51–2.00) and frailty (HR: 3.27, 95% CI: 2.77–3.87) were significantly higher than that for robust people. Furthermore, among participants who developed disabilities within 5 years (n = 1481), the risk of post‐disability death for pre‐frailty was not different from that for robust (HR: 1.49, 95% CI: 0.99–2.24), but frailty showed a higher risk of post‐disability death than did robust people. (HR: 1.75, 95% CI: 1.13–2.72). In the sex‐stratified analysis, although the female group showed no association between frailty status and post‐disability death (HR: 1.21, 95% CI: 0.63–2.33 in pre‐frailty; HR: 1.24, 95% CI: 0.60–2.57 in frailty), the male group showed higher risk of post‐disability death in both pre‐frailty (HR: 1.74, 95% CI: 1.03–2.96) and frailty (HR: 2.32, 95% CI: 1.32–4.09). Conclusions: Physical frailty shortens the period from disability onset to death. Additionally, the impact of frailty on post‐disability death is greater for males than for females. Our findings suggest that physical frailty is an important clinical indicator distinct from disability and that interventions to prevent and address frailty in men need further investigation. [ABSTRACT FROM AUTHOR]

Regular physical activity throughout life is generally recommended to prevent dementia; however, there is little evidence regarding the association between lifetime physical activity and mild cognitive impairment (MCI), which often precedes dementia. This study aimed to examine the association of lifetime physical activity and their transitions with late-life MCI. A population-based case-control study. A total of 2968 Japanese community-dwelling older adults aged ≥70 years without dementia. We evaluated the participants' early-, mid-, and late-life physical activity habits and categorized their transitions across life stages. Cognitive functions in late life were assessed for memory, attention, executive function, and processing speed; functional impairment in one or more cognitive domains was defined as MCI. Regular physical activity in early life was not significantly associated with late-life MCI [odds ratio (OR), 0.80; 95% CI, 0.63–1.02], although those in mid-life (OR, 0.64; 95% CI, 0.51–0.81) and late-life (OR, 0.74; 95% CI, 0.59–0.91) were associated with lower odds of late-life MCI. Compared with nonexercisers, participants who acquired new habits of physical activity during mid- or late-life (OR, 0.71; 95% CI, 0.55–0.91) and those who maintained physical activity throughout their life span (OR, 0.61; 95% CI, 0.42–0.87) had lower odds of late-life MCI; those who stopped regular activity during mid- or late-life did not (OR, 0.79; 95% CI, 0.58–1.06). While physical activity throughout the life span is associated with the lowest odds of MCI, starting regular physical activity, even later in life, confers a benefit and should be encouraged as a "lifelong approach" to MCI risk reduction. [ABSTRACT FROM AUTHOR]