Background: Sarcopenia significantly affects the health and quality of life in older adults. Exercise combined with nutritional interventions is widely recognized as an effective strategy for improving sarcopenia outcomes. However, current studies rarely focus on differential effects across subpopulations with distinct demographic and health characteristics. This study aimed to explore the effects of combined exercise and nutrition interventions on sarcopenia-related outcomes, considering the variations in population characteristics. Methods: A systematic search was conducted across PubMed, Embase, the Web of Science, and Cochrane Library, covering the literature published between January 2010 and March 2025. Only randomized controlled trials (RCTs) evaluating combined exercise and nutritional interventions for sarcopenia were included. The primary outcomes were handgrip strength (HS), the skeletal muscle mass index (SMI), gait speed (GS), and the five-times sit-to-stand test (5STS). The mean differences (MD) with 95% confidence intervals (CIs) were calculated. Random-effects models were used for the meta-analysis and subgroup comparisons. Results: Fifteen RCTs involving 1258 participants in the intervention group and 1233 in the control group were included. Exercise combined with nutritional interventions significantly improved sarcopenia-related outcomes. HS improved with a pooled MD of 1.77 kg (95% CI: 0.51 to 3.03, p = 0.006); SMI increased by 0.22 kg/m² (95% CI: 0.09 to 0.35, p = 0.0007); GS improved by 0.09 m/s (95% CI: 0.04 to 0.14, p = 0.0002); and 5STS performance improved with a time reduction of −1.38 s (95% CI: −2.47 to −0.28, p = 0.01). Subgroup analyses indicated that the intervention effects varied according to age, BMI, and living environment. Conclusions: Exercise combined with nutrition is effective in improving key outcomes associated with sarcopenia in older adults. The magnitude of these effects differed across population subgroups, underscoring the importance of tailoring interventions to specific demographic and health profiles.

Background: Physical exercise is an effective measure to prevent sarcopenia. However, the effects of Nordic walking based on high-intensity interval training (HIIT NW) and conventional strength training (ST) on the parameters related to sarcopenia in postmenopausal women remain unclear. Therefore, this study aims to evaluate the effects of 12-week HIIT NW and ST on body composition and physical function performance in postmenopausal women. Method: The participants were 71 women aged between 60 and 79 years old without sarcopenia. Participants were randomly assigned to the HIIT NW group (12-week Nordic walking training, 3 × /week), the ST group (12-week strength training, 3 × /week), and the control group. The body composition was determined by using Otupole InBody 720. Test the hand grip strength with a digital hand force gauge. The strength of the extensor and flexor muscles of the knee joint was measured using Biodex System 4 Pro™. This study also employed common methods for measuring functional performance and conducted two measurements of blood creatinine and creatine kinase. Result: Compared with the control group, significant improvements were observed in parameters such as Time Up and Go (TUG) and knee joint flexor strength (KFS) in both the HIIT NW group and the ST group. In the ST group alone, significant enhancements were noted in parameters including walking speed (GS) and hand strength on the left side (HS-L). Following the intervention, the HIIT NW group exhibited a marked increase in limb lean mass, which led to a significant rise in the skeletal muscle index (SMI) (p < 0.001). However, the body fat mass (BFM) and body mass index (BMI) decreased significantly in the ST group (p < 0.001 and p = 0.005, respectively). No significant changes were observed in the control group. Conclusion: Both HIIT NW and ST interventions can effectively prevent sarcopenia in postmenopausal women. The former focuses on improving lower limb strength, while the latter focuses on improving upper limb strength. In the short term, the HIIT NW intervention model is more beneficial for postmenopausal women with normal weight, while the conventional ST intervention model is more conducive to the overweight population.

Objectives: The objective of the study was to carry out an analysis of the methodological quality of clinical trials (effects of exercise on frailty in older people) based on ACSM recommendations. Methods: The search scope included PubMed, Embase, Web of Science, Cochrane, and literature that cannot be retrieved from the database. The topic was the impact of exercise on frailty in elderly people. Changes in five outcome measures (FP, BI, SPPB, GS, and BMI) were assessed using mean differences (MD) and 95% confidence intervals (95% CI). A random effects model (RE) was used to conduct a meta-analysis and compare the results between subgroups. Results: The intervention effects of exercise on the five outcome indicators of frailty in elderly people were all significant (p < 0.05). The effect of a high-consistency subgroup on outcome indicators FP and GS was more significant than that of the low- or uncertain-consistency subgroup (MD: −1.09 < −0.11, MD: 2.39 >1.1). There was no significant difference in the intervention effect as reflected in the outcome measures SPPB and BMI in the high-consistency subgroup (p = 0.07, p = 0.34). There was no significant difference in the impact of the intervention on the outcome measure BI between the two subgroups (p = 0.06, p = 0.14). Conclusions: Exercise prescriptions with high consistency with ACSM recommendations may be more effective in both FP and GS interventions than those with uncertain or low consistency. However, it is essential to note that the data derived from the meta-analysis is still subject to the small number of studies, the unknown degree of consistency of participants in individual studies, and the different mix of cases in the studies.

Background: The Otago Exercise Program (OEP) is suitable for frail older adults but has limited effect on sarcopenia. Resistance training (RT) is commonly used for sarcopenia. This study evaluated the effects of 12 weeks of OEP combined with RT on body composition, physical function, quality of life, and frailty in older adults with pre-sarcopenia in nursing homes. Methods: Sixty-one pre-frail elderly (aged 65– 89 years) with sarcopenia were randomly divided into experimental group (EG) and control group (CG). EG received OEP+RT training three times a week for 12 weeks, and CG maintained daily activities. The InBody 770 was used to assess body composition, Jamar Plus was used to measure grip strength, and international standard scales were used to assess physical function, quality of life and frailty. Results: Compared to the CG, the EG showed significant improvements in Skeletal Muscle Index (SMI: 5.79 vs 5.43, p=0.037), Skeletal Muscle Mass (21.8 vs 19.5, p=0.017), hand grip strength (19.31 vs 16.92, p=0.029), gait speed (0.9 vs 0.81, p< 0.001), and the Five-Times-Sit-to-Stand Test (13 vs 14.35, p< 0.001). Within the EG, both SMI and hand grip strength increased significantly compared to baseline levels (p< 0.001), whereas in the CG, they decreased significantly (p< 0.05). There was no significant improvement in frailty status observed in either group. Conclusion: OEP combined with RT can improve the sarcopenia-related parameters of the elderly in nursing homes. Short-term unreversed frailty may be related to insufficient intervention intensity or single dimension. Improved muscle and physical function may contribute to future improvements in quality of life and frailty.

Background: Exercise is increasingly recognized as a non-pharmacological strategy for cognitive aging; however, comparative evidence across modalities, phenotypes, and doses is limited. Methods: We conducted a Bayesian network meta-analysis of 38 randomized controlled trials ( N = 4,047; 88 arms). The interventions included aerobic, resistance, multimodal, and other exercise formats compared with non-exercise controls. The primary outcome was global cognition. Analyses were stratified by age (< 70 vs. ≥70 years) and phenotype (healthy vs. pre-sarcopenic). Dose–response relationships were modeled using the weekly volume (MET·min/week). Results: Aerobic (standardized mean difference [SMD] 0.58, 95% CI 0.33–0.83), resistance (0.62, 0.35–0.88), and multimodal programs (0.68, 0.40–0.95) significantly improved cognition compared to the control, with smaller effect sizes. Healthy older adults benefited most from aerobic (0.88, 0.55–1.20) and resistance training (0.80, 0.42–1.19), whereas multimodal programs were most effective for pre-sarcopenia (0.60, 0.29–0.90). Dose–response analysis showed clinically meaningful benefits from ~ 600 MET·min/week, with optimal effects between 700 and 1,200 MET·min/week. Higher volumes conferred no consistent additional gains in pre-sarcopenia. Conclusions: Exercise is a scalable, safe, and clinically effective approach for preserving late-life cognition. For healthy older adults, aerobic or resistance training at ≥ 600 MET·min/week is recommended; for pre-sarcopenic individuals, multimodal programs at approximately 700–800 MET·min/week offer the best balance of efficacy and sustainability. These findings provide actionable targets for clinicians and policymakers, advancing precision exercise prescriptions for cognitive health in aging populations.