The efficacy of different interventions in the treatment of sarcopenia in middle-aged and elderly people: A network meta-analysis

Abstract

Background: In this study, a meta-analysis system was used to evaluate the effects of 7 methods of treating sarcopenia, including resistance exercise, aerobic exercise, mixed exercise, nutrition, resistance combined with nutrition, mixed exercise combined with nutrition, and electric stimulation combined with nutrition, and their effects on physical function. Methods: According to the PRISMA guidelines, PubMed, Web of Science, Embase, and other foreign databases, as well as Chinese databases such as China National Knowledge Infrastructure and Wan Fang, the literatures of randomized controlled trials with different intervention measures were searched. ADDIS software was used to compare and rank the results of the network meta-analysis. Results: A total of 2485 patients were included in the 30 randomized controlled trial items. According to the clinical manifestations of sarcopenia, 7 different forms of exercise and nutrition interventions can improve muscle strength, muscle mass, and physical function; in terms of improving muscle strength, resistance exercise has the most significant effect on improving grip strength (MD = 2.58, 95% confidence interval [CI] [1.06–4.07]); resistance exercise combined with nutrition lifting performed best in chair standing test (MD = −2.37, 95% CI [−4.73 to −0.33]). For muscle mass gains, resistance training increased appendicular skeletal muscle mass significantly (MD = 0.90, 95% CI [0.11–1.73]), while resistance exercise combined with nutrition significantly increased fat-free mass (MD = 5.15, 95% CI [0.91–9.43]). For physical activity, resistance training improved walk speed best (MD = 0.28, 95% CI [0.15–0.41]), and resistance exercise combined with nutrition in the best results were seen in the timed up and go test (MD = −2.31, 95% CI [−4.26 to −0.38]). Conclusion: Compared with aerobic exercise, mixed exercise, nutrition, resistance combined with nutrition, mixed exercise combined with nutrition, and electric stimulation combined with nutrition, resistance exercise has more advantages in improving muscle mass, strength, and physical function performance. The clinical treatment of sarcopenia with resistance exercise intervention has a better curative effect.