Objectives: The aim of this study was to examine the relationship between frailty symptoms and HRQOL in older adults while using a measure of physical inactivity (PIA) as a frailty indicator.

Design: This was a cross-sectional study that included interview and examination data collected during the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES) periods.

Setting: Non-institutionalized community dwelling adults 65+ years of age.

Participants: Data were used from 3,536 adults with mean age of 72.7 years, majority female (55%), and majority non-Hispanic White (79%).

Measurements: Frailty symptoms were assessed using a modified Fried index including exhaustion, weakness, low body weight, and low activity replaced by a measure of PIA. PIA was assessed using five questions asking participants if they engage in (for at least 10 minutes) work, recreational, and transportation-related activity. Those responding “no” to all five questions were considered physically inactive. Demographic and health status covariates included sex, age, race, income, depression, IADL, frequency of healthcare use, BMI, smoking status, and sedentary time.

Results: Approximately 19.9% (95% CI: 17.2-22.5) of older adults reported poor HRQOL. After adjusting for demographic and health status covariates, odds of poor HRQOLwere significantly greater stepwise for each additional frailty symptom (OR=1.65, 95% CI: 1.37-2.00).

Conclusion: Results from this study show that using PIA as an indicator of frailty is useful in predicting HRQOL independent of covariates in older adults.