Effectiveness of Home-Based Exercise and Nutrition Programs for Senior Adults on Muscle Outcomes: A Scoping Review

Abstract

This scoping review investigates the volume of evidence for home-based exercise and nutrition programs and their effect on muscle quality among senior adults to inform implementation and future research. It aims to answer the research question: What are the evidence, challenges, and needs for research regarding a home-based exercise and nutrition intervention program to improve muscle outcomes in senior adults? This scoping review was conducted following the PRISMA extension for Scoping Review. The following databases were searched: PubMed, Scopus, MEDLINE, CINAHL, EMBASE, and the Cochrane Library. Applied filters were used to help condense the research articles. A total of 13 studies met the inclusion criteria for this scoping review. Most exercise interventions were either resistance or multi-component exercise programs. The nature of the nutrition intervention varied between different supplements, foods, education, or counseling. Muscle outcomes included muscle mass in nine studies, muscle function in all the studies, muscle strength in ten studies, and biochemical analyses in two studies. Two studies found improvements in muscle mass; two studies revealed improvements in all their muscle function tests; and three studies revealed improvements in muscle strength. Muscle biopsy in a study revealed enhanced muscle fibers, but both studies did not reveal any biomarker improvements. The scoping review findings revealed mixed results on the effectiveness of a home-based exercise and nutrition program. However, the current evidence does have many gaps to address before recommending this form of intervention for senior adults as an effective way to prevent and manage sarcopenia. Since this review identified multiple knowledge gaps, strengths, and limitations in this growing field, it can be a starting point to help build future study designs and interventions in this population.

Effect of Exercise Programs on Physical Performance in Community-Dwelling Older Adults with and without Frailty: Systematic Review and Meta-Analysis

“…All studies used the SPPB scale to assess the physical functioning of participating older adults. Five estimated the effect of physical exercise on the physical performance of those without frailty [ 17 , 18 , 19 , 20 , 21 ], while seven assessed the effect on those with frailty or pre-frailty [ 15 , 16 , 23 , 24 , 25 , 26 , 27 ]. All studies used Fried’s physical model or phenotype to determine frailty and pre-frailty.…”

“…The World Health Organization (2015) defined intrinsic capacity as “all the physical and mental capacities of an individual”, considering it a fundamental component of healthy aging [ 3 ]. For this reason, it is important to measure intrinsic capacity in healthy and independent older adults, and particularly in those with frailty, since it contributes to avoiding fractures and reducing dependency [ 27 , 28 , 29 , 30 ]. In this regard, the effect of exercise training on physical performance and its link with daily living activities in older adults with and without frailty is an issue of great interest for healthy aging.…”

“…Similarly, physical exercise programs aimed at older people with frailty that include nutritional intervention have been shown to increase the benefits of exercise [ 5 , 35 ]. In a systematic review whose objective was to determine the effectiveness of home exercise and nutrition programs on muscle quality in older adults, the authors found improvement in muscle mass, function and strength, as well as improved muscle fibers after intervention [ 27 ]. In contrast, a meta-analysis conducted by Choi et al (2021) reported that nutritional interventions with resistance training had no additional effect on body composition, muscle strength or physical function compared to the control group who received a placebo [ 36 ].…”

Effect of Exercise Programs on Physical Performance in Community-dwelling Older Adults With and Without Frailty. Systematic review and meta-analysis

“…All studies used the SPPB scale to assess the physical functioning of participating older adults. Five estimated the effect of physical exercise on the physical performance of those without frailty [15][16][17][18][19], while seven assessed the effect on those with frailty or pre-frailty [21][22][23][24][25][26][27]. All studies used Fried's physical model or phenotype to determine frailty and pre-frailty.…”

“…It has been shown that physical exercise prevents and/or delays the onset of aging disorders. Among other salient benefits, it strengthens functional capacity and reduces the risk of disability [27]. It is important to measure intrinsic capacity in healthy and independent older adults, and particularly in those with fraility, as it contributes to averting fractures and reduces dependence [28].…”