Yoshihiro Yoshimura1, Hidetaka Wakabayashi2, Minoru Yamada3, Hunkyung Kim4, Atsushi Harada5, Hidenori Arai6. 1. Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, Kumamoto, Japan. 2. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Kanagawa, Japan. 3. Department of Lifespan Developmental Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan. 4. Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan. 5. Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Aichi, Japan. 6. Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan. Electronic address: harai@ncgg.go.jp.
Abstract
BACKGROUND: Much interest has been focused on interventions for treating sarcopenia; however, the effects have gained little evidence. OBJECTIVE: To analyze the effectiveness of exercise, nutritional, drug, and combinational interventions for treating sarcopenia in older people. METHOD: We systematically searched MEDLINE via PubMed, the Cochrane Library of Cochrane Reviews and Cochrane Central Register of Controlled Trials, and Ichushi-Web for randomized controlled trials (RCTs) from January 2000 to December 2016. We have assessed the type of intervention, the cohort used, the way sarcopenia was diagnosed, the outcomes, and the quality of evidence. We meta-analyzed the outcomes with the net difference between-group treatment from baseline to the end of the study. RESULTS: We screened a total of 2668 records and included seven RCTs that investigated the effects of exercise (4 RCTs), nutrition (5 RCTs), drug (1 RCT), and combination (4 RCTs) on muscle mass, strength, and function in older people with sarcopenia. Very low to low-quality evidence suggests that (1) exercise interventions may play a role in improving muscle mass, muscle strength, and walking speed in 3 months of intervention; (2) nutritional interventions may be effective in improving muscle strength in 3 months of intervention; (3) as drug intervention, selective androgen receptor modulator had no clear effect on muscle mass, strength, and physical function; and (4) a combined intervention of exercise and nutrition may have positive effects in improving the walking speed in 3 months of intervention. CONCLUSION: Our systematic review and meta-analysis showed some positive effects of exercise and nutritional interventions for treating sarcopenia in older people, although the quality of the evidence was low. Future high-quality RCTs should be implemented to strengthen the results.
BACKGROUND: Much interest has been focused on interventions for treating sarcopenia; however, the effects have gained little evidence. OBJECTIVE: To analyze the effectiveness of exercise, nutritional, drug, and combinational interventions for treating sarcopenia in older people. METHOD: We systematically searched MEDLINE via PubMed, the Cochrane Library of Cochrane Reviews and Cochrane Central Register of Controlled Trials, and Ichushi-Web for randomized controlled trials (RCTs) from January 2000 to December 2016. We have assessed the type of intervention, the cohort used, the way sarcopenia was diagnosed, the outcomes, and the quality of evidence. We meta-analyzed the outcomes with the net difference between-group treatment from baseline to the end of the study. RESULTS: We screened a total of 2668 records and included seven RCTs that investigated the effects of exercise (4 RCTs), nutrition (5 RCTs), drug (1 RCT), and combination (4 RCTs) on muscle mass, strength, and function in older people with sarcopenia. Very low to low-quality evidence suggests that (1) exercise interventions may play a role in improving muscle mass, muscle strength, and walking speed in 3 months of intervention; (2) nutritional interventions may be effective in improving muscle strength in 3 months of intervention; (3) as drug intervention, selective androgen receptor modulator had no clear effect on muscle mass, strength, and physical function; and (4) a combined intervention of exercise and nutrition may have positive effects in improving the walking speed in 3 months of intervention. CONCLUSION: Our systematic review and meta-analysis showed some positive effects of exercise and nutritional interventions for treating sarcopenia in older people, although the quality of the evidence was low. Future high-quality RCTs should be implemented to strengthen the results.
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