Effectiveness of physical exercise on osteosarcopenia in older adults: a systematic review

Abstract

Background: Osteosarcopenia is a geriatric syndrome characterized by the coexistence of sarcopenia and osteopenia/osteoporosis, which can lead to frailty and mortality. The effectiveness of physical exercise on osteosarcopenia, particularly on muscular and skeletal parameters, remains unclear. This systematic review aimed to analyze the impact of exercise interventions on osteosarcopenia in older adults and to describe the diagnostic methods used in different clinical trials. Methods: Randomized clinical trials conducted in older adults ( 65 years) diagnosed with osteosarcopenia were included, sourced from PubMed, Embase, Cochrane, and Scopus databases without language or publication year restrictions, up to July 2024. Osteosarcopenia was defined as the coexistence of sarcopenia and osteopenia/osteoporosis based on dual-energy X-ray absorptiometry (DXA) criteria. Exercise interventions of at least four weeks were considered, with comparisons to non-exercise control groups. This systematic review followed the PRISMA guidelines and was registered in PROSPERO (CRD42016043310). Results: A total of 250 articles were identified, but only four studies met the eligibility criteria, involving 195 participants. All included studies utilized resistance training (RT) as the exercise intervention. The most common diagnostic criteria for osteosarcopenia were based on the T-score of the lumbar spine and/or femur, measured via DXA, using World Health Organization cut-off points for bone mineral density (BMD) and the criteria from the European Working Group on Sarcopenia in Older People for sarcopenia. RT was found to be effective in increasing strength and muscle mass in older adults diagnosed with osteosarcopenia, though it did not significantly improve physical performance. Conclusion: There are few studies on this topic, making it difficult to draw definitive conclusions regarding the effectiveness of physical exercise in older adults with osteosarcopenia. Resistance training showed positive results, particularly in improving strength and muscle mass.