Multidomain interventions for sarcopenia and cognitive flexibility in older adults for promoting healthy aging: a systematic review and meta-analysis of randomized controlled trials

As the global population ages, the prevalence of sarcopenia (loss of muscle mass and strength) and cognitive decline has become a major public health concern. These conditions are closely linked, contributing to frailty and loss of independence. This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of multidomain interventions—programs that integrate physical activity, cognitive stimulation, and social engagement—in mitigating these age-related declines.

The researchers followed PRISMA and PERSiST guidelines to identify relevant RCTs published up to November 2023. They screened 2,082 articles, ultimately including 17 in the systematic review and 8 in the meta-analysis. The interventions were required to last at least eight weeks and address both sarcopenia (or strength training) and cognitive flexibility. The meta-analysis utilized a random-effects model to assess functional outcomes, including the Sit to Stand (STS) test, Timed Up and Go (TUG) test, Trail Making Test (TMT), and Victoria Stroop Test (VST).

The analysis revealed that multidomain interventions are effective in improving physical performance, specifically demonstrating a significant improvement in lower limb muscle power as measured by the Sit to Stand test (p = 0.02). Regarding cognitive health, the results showed a positive trend toward improved cognitive flexibility (TMT) in the exercise groups compared to control groups (p = 0.05). While other measures like the TUG test showed a trend toward improvement, they did not reach statistical significance. The authors conclude that integrating physical and cognitive training is a viable non-pharmacological strategy to promote healthy aging and reduce the burden of age-related diseases.

This study provides evidence that exercise programs for older adults should not be limited to physical training alone. By incorporating cognitive and social components, these multidomain interventions address the multifaceted nature of aging. The findings support the development of public health policies that encourage dual-task training to help older adults maintain independence and cognitive function.