Effects of Exercise on Patients Important Outcomes in Older People With Sarcopenia: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

Yanjiao Shen; Dan Liu; Sheyu Li; Yazhou He; Fucha Tan; Xuelian Sun; Daiping Li; Xin Xia; Qiukui Hao

doi:10.3389/fmed.2022.811746

Effects of Exercise on Patients Important Outcomes in Older People With Sarcopenia: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

Front Med (Lausanne). 2022 Feb 3:9:811746. doi: 10.3389/fmed.2022.811746. eCollection 2022.

Authors

Yanjiao Shen¹, Dan Liu², Sheyu Li^{1

2}, Yazhou He³, Fucha Tan⁴, Xuelian Sun⁵, Daiping Li⁵, Xin Xia⁵, Qiukui Hao^{5

6}

Affiliations

¹ Department of Guideline and Rapid Recommendation, Cochrane China Centre, MAking GRADE the Irresistible Choice (MAGIC) China Centre, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu, China.
² Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
⁴ Department of Geriatrics, Affiliated Hospital of Heze Medical College, Heze, China.
⁵ The Center of Gerontology and Geriatrics/National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
⁶ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.

Abstract

Background: Many clinical practice guidelines strongly recommend exercise as an intervention for patients with sarcopenia. However, the significance of exercise on patient-important outcomes in older adults with sarcopenia is inconsistent when considering available minimal important differences. To synthesize current systematic review and meta-analyses evidence on the efficacy of exercise on patient-important outcomes in the treatment of sarcopenia in older adults.

Methods: We searched MEDLINE, EMBASE, Cochrane Library (Cochrane database of systematic review, CDSR) via OvidSP and Web of science until April 2021 and reference lists. Two independent investigators performed abstracted and title screening, assessed the full text and quality of evidence. This umbrella review included systematic reviews and meta-analyses of randomized controlled trials (RCTs). Eligible reviews aim to evaluate the effect of exercise on patient-important sarcopenic outcomes (muscle or physical function, mortality, and quality of life) in treating sarcopenia in older people. We used the minimally important differences (MIDs) of these outcomes to assess if the effects of exercise matter to patients.

Results: This umbrella review provided a broad overview of the existing evidence and evaluated the systematic reviews' methodological quality and evidence for all these associations. In older patients with sarcopenia, moderate- to high-quality evidence showed that exercise intervention probably increases walking speed and improved physical performance (measured by TUG test); exercise may increase the muscle strength (grip strength, keen extension strength); but the effect size for grip strength probably too small to achieve patients important changes. Evidence for older people with sarcopenic obesity is limited, and we found the consistent effect of exercise interventions on grip strength and usual walking speed.

Conclusion: Exercise has a positive and important effect on physical performance for older adults with sarcopenia, which supports leaving the current recommendations unchanged. New systematic reviews to summarize the effect of exercise on the quality of life are warranted to fill the current evidence gap.

Keywords: exercise; meta-analyses; randomized controlled trials; sarcopenia; umbrella review.

Publication types

Systematic Review