IMPACT OF RESISTANCE EXERCISE ON NEUROCOGNITIVE HEALTH AND SARCOPENIA IN THE ELDERLY
Abstract
Introduction: Sarcopenia (progressive muscle loss/weakness) and neurocognitive decline are serious, interrelated difficulties of aging, with shared pathophysiological pathways including inflammation and disrupted muscle-brain communication. Resistance exercise training (RET) counters sarcopenia and additionally may be beneficial for cognition via myokine release.
Methods: Systematic review (PubMed/Google Scholar) of the impact of RET on sarcopenia and neurocognitive health in adults aged ≥ 65 years was done. The search words were "resistance exercise", "sarcopenia", "neurocognitive health", and "elderly". Clinical studies, trials, meta-analyses, and RCTs after 2017 were included. After screening 348 records and applying exclusion criteria, 21 studies were analyzed.
Results: RET significantly improves sarcopenia, increasing muscle strength (e.g., knee extension SMD=1.26), mass (especially with protein supplementation), and physical function (e.g., gait speed SMD=1.28), reducing fall risk. RET also yields domain-specific cognitive improvements, most consistently in executive function and processing speed, that are coupled with hippocampal expansion and expanded functional connectivity. RET elevates neurotrophic factors (e.g., BDNF) and reduces inflammation (e.g., IL-6). Crucially, several studies demonstrate concurrent improvements in both cognition and muscle strength/function, with strength improvement being related to cognitive improvement (up to 40% mediation).
Discussion: RET provides two-fold protection through mechanisms like heightened protein synthesis, reduced inflammation, and neurotrophic support. Barriers include low adherence, access, and standardization of protocols (e.g., optimal dose: ≥2 sessions/week, 70–80% 1RM). Future research needs validated biomarkers, optimized protocols (including nutritional co-interventions), and high-quality RCTs on minimal effective doses and synergies.
Conclusions: RET is a robust, evidence-based intervention counteracting both sarcopenia and cognitive impairment in older adults, and promoting functional independence and healthy aging. The resolution of implementation concerns and outstanding research questions is necessary to maximize its public health impact.
References
Yuan S, Larsson SC. Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. doi:10.1016/j.metabol.2023.155533
Choo YJ, Chang MC. Prevalence of Sarcopenia Among the Elderly in Korea: A Meta-Analysis. J Prev Med Public Health. 2021;54(2):96-102. doi:10.3961/jpmph.21.046
Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13(1):86-99. doi:10.1002/jcsm.12783
Cruz-Jentoft AJ, Sayer AA. Sarcopenia [published correction appears in Lancet. 2019 Jun 29;393(10191):2590. doi: 10.1016/S0140-6736(19)31465-5.]. Lancet. 2019;393(10191):2636-2646. doi:10.1016/S0140-6736(19)31138-9
Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. doi:10.1016/S0140-6736(20)30367-6
Xu J, Wan CS, Ktoris K, Reijnierse EM, Maier AB. Sarcopenia Is Associated with Mortality in Adults: A Systematic Review and Meta-Analysis. Gerontology. 2022;68(4):361-376. doi:10.1159/000517099
Liu-Ambrose T, Barha CK, Best JR. Physical activity for brain health in older adults. Appl Physiol Nutr Metab. 2018;45(10)(Suppl 2):S1-S8. doi:10.1139/apnm-2018-0260
Sardeli AV, Komatsu TR, Mori MA, Gáspari AF, Chacon-Mikahil MPT. Resistance Training Prevents Muscle Loss Induced by Caloric Restriction in Obese Elderly Individuals: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(4):423. doi:10.3390/nu10040423
Morton RW, Murphy KT, McKellar SR, et al. A systematic review, meta-analysis, and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med. 2018;52,(6):376-384. doi:10.1136/bjsports-2017-097608
Zhao H, Cheng R, Song G, et al. The Effect of Resistance Training on the Rehabilitation of Elderly Patients with Sarcopenia: A Meta-Analysis. Int J Environ Res Public Health. 2022;19(23):15491. doi:10.3390/ijerph192315491
Lu L, Mao L, Feng Y, Ainsworth BE, Liu Y, Chen N. Effects of different exercise training modes on muscle strength and physical performance in older people with sarcopenia: a systematic review and meta-analysis. BMC Geriatr. 2021;21(1):708. Published 2021 Dec 15. doi:10.1186/s12877-021-02642-8
Yoon DH, Lee JY, Song W. Effects of Resistance Exercise Training on Cognitive Function and Physical Performance in Cognitive Frailty: A Randomized Controlled Trial. J Nutr Health Aging. 2018;22(8):944-951. doi: 10.1007/s12603-018-1090-9
Schoenfeld, B. J., Ogborn, D., & Krieger, J. W. Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis. Journal of Sports Sciences. 2016;35(11), 1073–1082. doi:10.1080/02640414.2016.1210197
Dos Santos EEP, de Araújo RC, Candow DG, et al. Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients. 2021;13(11):3757. doi:10.3390/nu13113757
Burtscher J, Ticinesi A, Millet GP, Burtscher M, Strasser B. Exercise-microbiota interactions in aging-related sarcopenia. J Cachexia Sarcopenia Muscle. 2022 Apr;13(2):775-780. doi: 10.1002/jcsm.12942
Papadopoulou SK, Tsintavis P, Potsaki P, Papandreou D. Differences in the Prevalence of Sarcopenia in Community-Dwelling, Nursing Home and Hospitalized Individuals. A Systematic Review and Meta-Analysis. J Nutr Health Aging. 2020;24(1):83-90. doi: 10.1007/s12603-019-1267-x
Yeung SSY, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CGM, Maier AB. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2019 Jun;10(3):485-500. doi: 10.1002/jcsm.12411
Fairchild JK, Myers J, Louras P, et al. Multimodal exercise and cognitive training program improves cognitive function in amnestic mild cognitive impairment. Am J Geriatr Psychiatry. 2024;32(4):463-474. doi: 10.1016/j.jagp.2023.12.002
Nuzum H, Stickel A, Corona M, Zeller M, Melrose RJ, Wilkins SS. Potential Benefits of Physical Activity in MCI and Dementia. Behav Neurol. 2020 Feb 12;2020:7807856. doi:10.1155/2020/7807856
Quigley A, MacKay-Lyons M, Eskes G. Effects of Exercise on Cognitive Performance in Older Adults: A Narrative Review of the Evidence, Possible Biological Mechanisms, and Recommendations for Exercise Prescription. J Aging Res. 2020 May 14;2020:1407896. doi: 10.1155/2020/1407896
Malmberg Gavelin H, Dong C, Minkov R, et al. Combined physical and cognitive training for older adults with and without cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials. Ageing Res Rev. 2021;76:101591. doi: 10.1016/j.arr.2020.101232
Mavros Y, Gates N, Wilson GC, Jain N, Meiklejohn J, Brodaty et. al. Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training. J Am Geriatr Soc. 2017 Mar;65(3):550-559. doi: 10.1111/jgs.14542
Zunner BEM, Wachsmuth NB, Eckstein ML, Scherl L, Schierbauer JR, Haupt S, Stumpf C, Reusch L, Moser O. Myokines and Resistance Training: A Narrative Review. Int J Mol Sci. 2022 Mar 23;23(7):3501. doi: 10.3390/ijms23073501
Cheng X, Yang Z. Effect of resistance training on inflammatory markers in middle-aged and older adults: A meta-analysis. Arch Gerontol Geriatr. 2024 Nov;126:105536. doi:10.1016/j.archger.2024.105536
Rivero-Segura NA, Flores-Aguilar L, Barrera-Vázquez OS, et al. Promising biomarkers of human aging: in search of a multi-omics panel to understand the aging process from a multidimensional perspective. Ageing Res Rev. 2020;63:101164. doi:10.1016/j.arr.2020.101164
Sachdev PS, Lipnicki DM, Kochan NA, et al. The prevalence of mild cognitive impairment in diverse geographical and ethnocultural regions: the COSMIC collaboration. PLoS One. 2015;16(11):e0259228. doi:10.1371/journal.pone.0142388
Scheltens P, De Strooper B, Kivipelto M, et al. Alzheimer’s disease. Lancet Neurol. 2021;20(6):484-496. doi:10.1016/S0140-6736(20)32205-4
Peng TC, Chen WL, Wu LW, Chang YW, Kao TW. Sarcopenia and cognitive impairment: A systematic review and meta-analysis. Clin Nutr. 2020;39(9):2695-2701. doi:10.1016/j.clnu.2019.12.014
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