Exercise and Nutritional Interventions for Muscle Strength, Physical Performance, and Body Composition Among Older Adults With Sarcopenia or Pre-Sarcopenia: A Network Meta-Analysis.
HongXia Yang, Qian Wang, BiQing Wang et al.
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In 30 seconds
This network meta-analysis compared exercise, nutritional, and combined interventions with control strategies in older adults with sarcopenia or pre-sarcopenia. It included 57 randomized controlled trials involving 6017 participants. All three intervention types improved handgrip strength versus control, with combined exercise and nutrition showing the largest estimate (mean difference 4.29 kg, 95% CI, 2.50-6.07). Combined interventions also ranked highest for appendicular skeletal muscle mass index, while exercise showed benefits across physical-performance measures. Overall certainty of evidence was limited.
Key findings
- Combined exercise and nutrition had the largest handgrip-strength estimate versus control: mean difference 4.29 kg (95% CI, 2.50-6.07).
- Exercise improved Timed Up and Go performance (mean difference 1.19 s, 95% CI, 0.72-1.66) and ranked highly for gait speed (mean difference 0.11 m/s, 95% CI, 0.06-0.17).
- Combined intervention ranked highest for appendicular skeletal muscle mass index (mean difference 0.32 kg/m², 95% CI, 0.17-0.48).
- The authors rated overall certainty of evidence as limited.
Why it matters
Sarcopenia and pre-sarcopenia involve outcomes that may respond differently to exercise and nutritional strategies. These comparative estimates suggest that combined approaches may be more favorable for selected muscle-related measures, while exercise may offer broader physical-performance benefits. The limited certainty means the findings are informative for understanding intervention effects but do not establish a definitive ranking.
What to keep in mind
Overall certainty of evidence was limited according to CINeMA, and the authors call for confirmation in high-quality trials.