Physical Exercise In Older Adults Research Articles

Risk of frailty and associated factors among community older adults during the COVID-19 pandemic

Introduction: Functional decline represents the main determinant of negative outcomes in the health of older adults, such as the development of other disabilities, which may result in frailty, institutionalization, hospitalization and death. Aim: To determine the prevalence of risk of frailty among community older adults during the covid-19 pandemic and identify its association with health risk behaviors. Methods: An epidemiological screening type research, with cross-sectional design and sample representative of the Federal District, Brazil, was carried out. Data were collected through electronic questionnaire. In order to answer the problem question, the Clinical-Functional Vulnerability Index – IVCF-20 instrument was used (with risk ≥7 points), complemented by questions about demographic factors, socioeconomic factors and health risk behaviors. For data analysis, descriptive (frequency distribution and confidence interval) and association (crude and adjusted binary logistic regression) procedures were used. Results: Data from 1,363 older adults were analyzed (66.0%=female; 34.0%=male), the majority aged 60-74 years (82.2%), with higher education level (50.1%), who did not live alone (76.6%). There was high prevalence of older adults exposed to risk of frailty (30.7%; CI 95%=26.3-35.1), insufficiently active (45.6%; CI 95%=41.7-49.5) and who did not practice physical exercises before (30.2%; CI 95%=25.8-34.6) and during the physical distancing resulting from the covid-19 pandemic (53.4%; CI95%=49.8-57.0). Risk of frailty was associated with insufficient level of physical activity (OR=3.37; 95% CI 2.59-4.39) and with not practicing physical exercise before (OR=1.54; 95% CI 1. 17-2.03) and during physical distancing resulting from the covid-19 pandemic (OR=2.07; 95% CI 1.58-2.69). Conclusions: Considering the relevance and potential of physical exercise for older adults in contributing to functional improvement and health conditions, strategies to maintain active habits, even in periods of physical distancing as imposed by the covid-19 pandemic, are needed.

Are men dominant? Evidence of differences between physical activity and quality of life among older adults in China.

At present, the aging population is one of China's basic national concerns, and physical exercise offers endless potential to cope with it. However, the life expectancy of men in China is generally lower than that of women, and the health status of older men is more worrying. Could it be that differences in physical exercise cause the difference in life expectancy between older men and women? This study analyzes the exercise regimen of older men and women and its influence on their quality of life. Approximately 200 respondents aged over 60 were investigated using the SF-36 and exercise questionnaires. Our findings revealed the following: (1) The scores of seven dimensions of life quality of older men were significantly lower than those of older women (p < 0.001), but there was no significant difference only in physiological function (p > 0.05); (2) The exercise frequency and persistence of older men were significantly lower than those of older women (p < 0.001), but there was no significant difference in exercise time (p > 0.05); and (3) All eight indices of quality of life of older men were positively correlated with the four indices of exercise (0.250 < R < 0.597). Our study offered the following conclusions: (1) The health of older men who lack physical exercise is poor. From the perspective of healthy aging, older men are a vulnerable group that deserves more attention. (2) Within an appropriate range, the more older men participate in physical activity programs, the more conducive they are to improved health. (3) This study focuses on promoting physical exercise for older adults and suggests organizing them to participate in sports activities as an important measure to promote healthy aging in China.

Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

BackgroundGeneralised anxiety disorder (GAD) is a frequent and severe disorder among older adults. For older adults with GAD the effect of the recommended treatment, cognitive behaviour therapy (CBT), is reduced. Physical exercise (PE) may enhance the effect of CBT by improving cognitive function and increasing levels of brain-derived neurotrophic factor (BDNF), a predictor of the effect of CBT in patients with anxiety. The aim of the study was to assess the feasibility of a randomized controlled trial (RCT) investigating treatment effect of the combination of CBT and PE for GAD in a sample of older adults, including procedures for assessment and treatment.MethodsFour participants aged 62–70 years (M = 65.5, SD = 3.2) with a primary diagnosis of GAD were included. Participants received 15 weeks of PE in combination with 10 weeks of CBT. Participants completed self-report measures, and clinical, biological, physiological and neuropsychological tests at pre-, interim- and post-treatment.ResultsProcedures, protocols, and results are presented. One participant dropped out during treatment. For the three participants completing, the total adherence to PE and CBT was 80% and 100%, respectively. An independent assessor concluded that the completers no longer fulfilled the criteria for GAD after treatment. Changes in self-report measures suggest symptom reduction related to anxiety and worry. The sample is considered representative for the target population.ConclusionsThe results indicate that combining CBT and PE for older adults with GAD is feasible, and that the procedures and tests are suitable and manageable for the current sample.Trial registrationClinicalTrials.gov, NCT02690441. Registered on 24 February 2016, https://clinicaltrials.gov/ct2/show/NCT02690441.

A-01 Trait Mindfulness Gains Associated with Executive Functioning Improvements Following Physical Exercise in Older Adults

Abstract Purpose Although there are certain injury risks associated with sports participation (e.g., concussion), there are also neuropsychological benefits relating to physical activity. Evidence suggests that trait mindfulness (TM) may contribute to the neuropsychological benefits of physical activity and exercise, including those pertaining to executive functioning (EF) and mood. The present study aimed to investigate the degree to which changes in TM accounted for changes in neuropsychological functioning following a remote physical exercise training program for older adults. It was hypothesized that increases in TM would predict improvements in self-reported EF and symptoms of depression and anxiety. Methods As part of a larger RCT, 43 older adults (70% females, 65-81 years-old) from across Canada completed an online assessment measuring TM, EF, and mood before and after engaging in an 8-week remote physical exercise training program. Results Linear regression analyses showed that pre-post changes in TM explained a significant proportion of variance in self-reported changes in EF, r2=.18, F(1,24)=5.11, p&amp;lt;.05, but did not for symptoms of depression, r2=.06, F(1,24)= 1.53, p= 23 or anxiety, r2=.04, F(1,24)=1.08, p=.31. More specifically, bivariate correlations demonstrated that gains in TM were significantly associated with increases in reported impulse control, r=.48, p=.01, and empathy, r=.42, p&amp;lt;.05. Conclusions These results suggest that for older adults engaging in exercise, gains in trait mindfulness may be associated with benefits to certain aspects of executive functioning. These findings also invite sports neuropsychologists to consider level of mindfulness when evaluating individuals (e.g., athletes) engaged in exercise.

Real-Life Outcomes of a Multicomponent Exercise Intervention in Community-Dwelling Frail Older Adults and Its Association with Nutritional-Related Factors.

Most of the studies on physical exercise in older adults have been conducted through randomized clinical trials performed under tight experimental conditions. Data regarding Real-Life physical exercise intervention programs in older adults with different conditions and in different settings, are lacking. This is an interventional, prospective and pragmatic Real-Life study in which fifty sedentary and frail individuals were enrolled. We aimed at determining if a Real-Life exercise intervention outweighs previously reported improvements in a Clinical Trial (NCT02331459). We found higher improvements in the Real-Life exercise intervention vs. the Clinical Trial in functional parameters, such as Fried's frailty criteria, Tinetti, Barthel and Lawton & Brody scales. Similar results were found in the dietary habits, emotional and social networking outcomes determined through the Short-MNA, Yesavage, EuroQol and Duke scales. The Real-Life intervention led to a significant reduction in the number of falls, visits to the primary care centers and emergency visits when compared to the results of our previously published Clinical Trial. The implementation of a Real-Life exercise intervention is feasible and should be a major priority to improve health-span in the older population.

Body, Meanings, and Physical Exercise in Older Adults: The Qualitative Perspective of Frequent Gym-Goers

It is known that rates of participation in sports and physical activities among older adults decrease as they get older. This article focuses on the experience of the aging body at the gym, and it is one of the few that focuses on a little-studied group of frequent gym-goers. Based on an ethnographic work of more than two years in Amsterdam, I explain the goals of three older adults who frequently work out, what their relationships with the gym and their bodies are, and why they are interested in training in gyms. This article seeks to contribute to discourses on health, sport, and aging and, at the same time, to explain some of the advantages of qualitative studies in understanding the experience of aging and training in gyms.

Does Real-time Online Physical Exercise Improve Physical Fitness in Seniors?

ABSTRACT The need to interrupt in-person physical exercise due to the COVID-19 pandemic required the design of alternatives. Thus, the aim was to evaluate the effectiveness of an 8-month online physical exercise on physical fitness and body composition in community-dwelling older adults. This is a non-randomized controlled trial comprising 62 older adults (74.59 ± 5.79 years, 59.7% women) distributed in an exercise group (EG) that executed an 8-month online physical exercise (three sessions/week, multicomponent regime), or control group (CG). Changes in groups over time were modeled using a linear mixed model. The EG did not improve physical fitness nor body composition. After adjustments for age, sex, and body fat, there was a minimal significant benefit for lower body strength favoring the EG [group*time interaction 1.55 (0.65); p = .020]. In conclusion, online physical exercise did not improve but maintained overall physical fitness. The in-person physical exercise for older adults must be re-opened as soon as this population is going to be protected from COVID-19.

Sleep Quality and Quality of Life Among Older Adults During COVID-19 Pandemic: A Cross-Sectional Study.

Although home confinement reduces the number of SARS-CoV-2 infections, it may negatively impact the psychological and physical health of older adults. The present study attempted to describe the quality of life (QoL) of older adults before and during the COVID-19 outbreak, focusing on evaluating QoL, physical activity, sitting time, and sleep quality during home confinement. The present study was conducted in 1,063 older adults (91 % females) enrolled in a Brazilian social program. They were interviewed for QoL (EQ-5D), physical activity (international physical activity questionnaire-short), and sleep quality [Pittsburgh sleep quality index (PSQI)] after 11.6 ± 2.4 weeks of confinement. Logistic regression confirmed changes in QoL. The QoL (86.5 ± 14.7) decreased significantly during confinement (66.0 ± 21.0; P < 0.001), whereas the PSQI global score was 6.8 ± 3.9 points. Older adults spent 18.7 ± 29.8 min/day in moderate to vigorous physical activity, whereas they spent 325.5 ± 144.4 min/day sitting. The PSQI global score [odds ratio (OR): 1.10], sitting time (OR: 1.001), and diseases (OR: 1.23) were significantly associated with low QoL (P < 0.05). Confinement has a deleterious effect on QoL, which is influenced by quality of sleep, sitting time, and disease. Awareness regarding the significance of sleep and physical exercise in older adults can mitigate the damage to their health during confinement.

Motives for physical exercise in older adults from different contexts: typology and organization in practice

This study was undertaken to understand the reasons related to typology and organization in physical practice taking into account the perceptions of the older adults. Four focus groups were conducted with a total of 39 older adults. The study participants consisted of 30 women and 9 men (mean age of men and women was M = 68 and 67.1, SD = 4.7 years, respectively), from three contexts. These environments were rural area, a neighbourhood at risk of exclusion and a high socio-economic urban context. The methodological analysis is inductive, emergent, delineating the speeches from the specific to the general, through the process of codifying the grounded theory. Several factors appeared after the emergent analysis of the interventions of older adults. In this line, social support and goal setting were prominent factors that served as facilitators for adherence to physical exercise programs. The encouragement and company of others were factors that facilitated adherence to the physical exercise. Relating to sex differences, older male adults prefer to exercise alone, compared to women. Researchers and health professionals can use these results to tailor motivational messages and promote health-enhancing behavioural interventions for older adult populations.

Recruitment methods and yield rates in a clinical trial of physical exercise for older adults with hypertension\u2014HAEL Study: a study within a trial

BackgroundAlthough the prevalence of hypertension is high in older adults, clinical trial recruitment is a challenge. Our main aim was to describe the HAEL Study recruitment methods and yield rates. The secondary objectives were to explore the reasons for exclusion and to describe the characteristics of the enrolled participants.MethodsThis is a descriptive study within a trial. The HAEL Study was a Brazilian randomized two-center, parallel trial with an estimated sample of 184 participants. The recruitment strategy was based on four methods: electronic health records, word of mouth, print and electronic flyer, and press media. The yield rate was the ratio of the number of participants who underwent randomization to the total number of volunteers screened, calculated for overall, per recruitment method, by study center and by age group and sex. Additionally, we described the reasons for exclusion in the screening phase, as well as the demographic characteristics of those enrolled. The data are presented in absolute/relative frequencies and mean ± standard deviation.ResultsA total of 717 individuals were screened, and 168 were randomized over 32 months. The yield rate was higher for word of mouth (30.1%) in the overall sample. However, press media contributed the most (39.9%) to the absolute number of participants randomized in the trial. The coordinating center and participating center differed in methods with the highest yield ratios and absolute numbers of randomized participants. The main reason for exclusion in the screening phase was due to the physically active status in those intending to participate in the study (61.5%). Out of 220 participants included, 52 were excluded mainly because they did not meet the eligibility criteria (26.9%). Most of the screened volunteers were women (60.2%) age 60–69 years (59.5%), and most of the randomized participants were Caucasian/white (78.0%).ConclusionsMultiple recruitment methods constituted effective strategies. We observed that approximately one of every four individuals screened was allocated to an intervention group. Even so, there were limitations in obtaining a representative sample of older Brazilian adults with hypertension. Data show an underrepresentation of race and age groups.Trial registrationThis SWAT was not registered.

Heart Rate Variability During Physical Exercise Is Associated With Improved Cognitive Performance in Alzheimer's Dementia Patients-A Longitudinal Feasibility Study.

Heart rate variability (HRV) rapidly gains attention as an important marker of cardiovascular autonomic modulation. Moreover, there is evidence for a link between the autonomic deficit measurable by reduced HRV and the hypoactivity of the cholinergic system, which is prominently affected in Alzheimer's disease (AD). Despite the positive influence of physical exercise on cognition and its promising association with HRV, previous studies did not explore the effect of long-term physical exercise in older adults with AD. Taking advantage of a longitudinal study we analyzed the effect of a 20-week dual task training regime (3 × 15-min per week) on the vagal mediated HRV index RMSSD (root mean square of successive RR interval differences) during physical exercise and the short-term memory performance in a AD cohort (N = 14). Each training contained physical exercise on a bicycle ergometer while memorizing 30 successively presented pictures as well as the associated post-exercise picture recognition memory test. Linear-mixed modeling revealed that HRV-RMSSD significantly increased over the intervention time. Moreover, the reaction time in the picture recognition task decreased while the accuracy remained stable. Furthermore, a significantly negative relationship between increased fitness measured by HRV-RMSSD and decreased reaction time was observed. This feasibility study points to the positive effects of a dual task regime on physical and cognitive fitness in a sample with impaired cognitive performance. Beyond this, the results show that the responsiveness of parasympathetic system as measured with HRV can be improved in patients with dementia.

Effectiveness of Physical Exercise in Older Adults With Mild to Moderate Depression.

We sought to compare the effectiveness of physical exercise with that of treatment with antidepressant drugs routinely used in clinical practice, in terms of decreasing depressive symptomatology in patients aged ≥65 years who present with clinical criteria of a depressive episode. We conducted a randomized clinical trial in a primary care setting. A total of 347 patients aged ≥65 years with a clinically significant depressive episode were randomized to participation in a supervised physical exercise program or to receive antidepressant treatment by their general practitioners. Intention-to-treat analysis showed that the cumulative incidence of improvement in depressive symptomatology (Montgomery-Åsberg Depression Rating Scale score <10) in the physical activity (PA) group after 1 month was not significantly different from that in the antidepressant treatment (AT) group. However, the proportion of those who showed improvement was significantly greater (P <.01) in the AT group (60.6% and 49.7%) compared to the PA group (45.6% and 32.9%) at the end of 3 and 6 months, respectively. The number of withdrawals was greater in the PA group (39.2% and 58.2%) compared to the AT group (22.6% and 40.0%) at 3 and 6 months, respectively, yet the proportion of participants with adverse side effects was greater in the AT group (8.9% vs 22.5%; P = .007). Although improvement was initially similar in both treatment groups, AT was superior in the medium term, despite giving rise to a greater number of adverse effects.

Effects of Open-Skill Exercises on Cognition on Community Dwelling Older Adults: Protocol of a Randomized Controlled Trial.

(1) Cognitive function may benefit from physical exercise in older adults. However, controversy remains over which mode of exercise is more beneficial. (2) The aim of the proposed study is to investigate the effect of open-skill exercise training on cognitive function in community dwelling older adults compared with closed-skill exercise, cognitive training, and active control. (3) One hundred and sixty participants, aged between 60 and 80 years old, will be recruited from community senior centers in Yangzhou, China and randomly assigned to one of four groups: open-skill exercise group, closed-skill exercise group, mobile game playing group, and active control group. All participants will join a 24-week program involving 50 min sessions three times a week. The primary outcome measure is visuospatial working memory. Secondary measures include subjective memory complaint, attention network, nonverbal reasoning ability, and physical activities. All participants will be measured before, mid-way, and immediately after intervention, and three months later. (4) If successful, this study is expected to provide evidence-based recommendations for older adults to select the most efficient and effective mode of exercise to improve cognitive function. Importantly, the three intervention groups provide an opportunity to separate the cognitive activity component from the physical activity component. Comparison of these components is expected to help elucidate possible mechanisms contributing to the additional cognitive benefit of open-skill exercises.

Effect of physical exercise on cognitive function in older adults' carriers versus noncarriers of apolipoprotein E4: systematic review and meta-analysis.

The presence of apolipoprotein (Apo) E4 is a genetic risk factor in cognitive impairment. Physical exercise contributes to slowing cognitive impairment in older adults, but little is known about the influence of exercise on ApoE4 carriers and noncarriers. The objective of systematic review is to study the role of physical exercise in older adults’ ApoE4 carriers and noncarriers. A systematic literature search was carried out in five international databases: PubMed, Web of Science, PeDro, Scopus, and SPORTDiscus. A total of nine randomized controlled trials were included with a sample size of 2,025 subjects (901 ApoE4 carriers). The exercise reported a significant improvement on cognitive performance in older adults’ ApoE4 noncarriers (standardized mean difference [SMD]=0.653; 95% confidence interval [CI], 0.29–1.00; chi2=35.36; degrees of freedom [df ]=7; P<0.0001; l 2=80%). It was also reported that a total program duration greater than 50 sessions generated different and significant effects on cognitive performance in older adults’ ApoE4 noncarriers (SMD=0.878; 95% CI, 0.14–1.61; chi2=31.82; df=3; P<0.0001; l 2=91%). The results reported that high intensity generated a differential effect on cognitive performance in older adults’ ApoE4 carriers versus noncarriers (SMD=0.963; 95% CI, 0.25–1.67; chi2=18.11; df=3; P<0.0004; l 2=83%). The effect of physical exercise on cognitive performance in older adults is conditioned by the presence or not of ApoE4.

Impacto del ejercicio físico en variables relacionadas con el bienestar emocional y funcional en adultos mayores

Background and aimThe benefits of the physical exercise in aging, and specially in frailty, have been associated with reduced risk of mortality, chronic disease, and cognitive and functional impairments. Multi-component training, which combines strength, endurance, balance, and gait training, represents the most beneficial kind of physical exercise in older adults. MethodsGiven the effectiveness of the multi-component training, a physical exercise program «Actívate» (based on the methodology Vivifrail), with the focus on «active aging», was conducted in the present study. Forty-nine older adults over 60 years participated in this program. ResultsThe physical exercise intervention led to a reduction in diastolic blood pressure, pain threshold and sleep disturbances (e. g. hypersomnia) (t ≥ 2.72, p < 0.01), as well as an increase of walking speed (t = 7.84, p ≤ 0.001). Further, quality of life factors (GENCAT scale), like emotional well-being, personal development, physical well-being, self-determination, and social inclusion, were greater after intervention (t ≥ −2.06, p < 0.05). ConclusionsThese findings underline the benefits of multi-component training in functionality of older adults, and further, provide relevant aspects about the modulation of pain perception, sleep disturbances, social factors and physical and emotional well-being. Physical exercise programs such as «Actívate» should be promoted, in order to encourage healthy lifestyle habits, in the older adults’ population.

Neurocognitive Plasticity Is Associated with Cardiorespiratory Fitness Following Physical Exercise in Older Adults with Amnestic Mild Cognitive Impairment.

Aerobic training has been shown to promote structural and functional neurocognitive plasticity in cognitively intact older adults. However, little is known about the neuroplastic potential of aerobic exercise in individuals at risk of Alzheimer's disease (AD) and dementia. We aimed to explore the effect of aerobic exercise intervention and cardiorespiratory fitness improvement on brain and cognitive functions in older adults with amnestic mild cognitive impairment (aMCI). 27 participants with aMCI were randomized to either aerobic training (n = 13) or balance and toning (BAT) control group (n = 14) for a 16-week intervention. Pre- and post-assessments included functional MRI experiments of brain activation during associative memory encoding and neural synchronization during complex information processing, cognitive evaluation using neuropsychological tests, and cardiorespiratory fitness assessment. The aerobic group demonstrated increased frontal activity during memory encoding and increased neural synchronization in higher-order cognitive regions such as the frontal cortex and temporo-parietal junction (TPJ) following the intervention. In contrast, the BAT control group demonstrated decreased brain activity during memory encoding, primarily in occipital, temporal, and parietal areas. Increases in cardiorespiratory fitness were associated with increases in brain activationin both the left inferior frontal and precentral gyri. Furthermore, changes in cardiorespiratory fitness were also correlated with changes in performance on several neuropsychological tests. Aerobic exercise training may result in functional plasticity of high-order cognitive areas, especially, frontal regions, among older adults at risk of AD and dementia. Furthermore, cardiorespiratory fitness may be an important mediating factor of the observed changes in neurocognitive functions.

Effectiveness of Physical Exercise in Older Adults with Mild to Moderate Depression

Depression is a common and disabling bug that affects additional than 120 million people worldwide and a minimum of 1 in every 5 people over the course of their date. Although depression is routinely treated with antidepressant medicaments and/ or inner corrective, other healing druthers have admitted growing attention in recent days. Physical exercise in particular might be beneficent for depressed cases and substitute to antidepressant treatment.

One-repetition submaximal protocol to measure knee extensor muscle strength among older adults with and without sarcopenia: a validation study

BackgroundDynamic knee extensor muscle strength is a valid measure among healthy older adults but has not been tested in the sarcopenia condition. This study’s objective was to test the validity of a one-repetition submaximal strength protocol to measure dynamic knee extension strength in older adults with and without sarcopenia.MethodsNinety-four physically independent older adults (female: n = 64, 60 to 85 years; male: n = 29, 60 to 85 years) participated in this study in Brazil during 2016–2017. Sarcopenia was classified and isokinetic unilateral knee extension strength was measured at 60°/s. Bilateral dynamic knee extension strength was estimated with an extensor chair using one-repetition submaximal protocol. Validity was determined using Spearman’s correlation with isokinetic muscle strength.ResultsThe frequency of sarcopenia was 11.7%. Sarcopenic individuals presented lower body mass, body mass index and skeletal muscle index. Only chronological age was higher among the sarcopenic individuals. A high correlation was found between isokinetic unilateral knee extension strength and bilateral estimated one-repetition with submaximal protocol (r = 0.74; p <  0.001), when the presence (r = 0.71; p = 0.014) and absence of sarcopenia (r = 0.74; p <  0.001) were considered. The validity of the one-repetition submaximal protocol for bilateral knee extension was confirmed.ConclusionsThe estimated measure of bilateral knee extension muscle strength can be used to monitor adaptations promoted by physical exercise for older adults with and without sarcopenia. The validation enable studies that will propose cutoff points to identify sarcopenia with this submaximal protocol. This will enable early diagnosis and better management of sarcopenia, a disease with adverse impacts for older adults.

Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions.

Multicomponent physical exercise is effective in curbing the effect of hospitalization in older adults. However, it is not well established which characteristics of the exercise interventions would optimize intervention sustainability and efficacy. This study compared the effects of two group-based multicomponent exercise interventions of different lengths in older adults after hospitalization. Fifty-five participants were randomly assigned to a short-term group-based branch (SGB, n = 27) or to a long-term group-based branch (LGB, n = 28). The SGB participated in a six-week multicomponent group-based exercise-training program followed by 18 weeks of home-based exercise. The LGB completed 12 weeks of each phase. Physical function, physical activity, quality of life, anthropometrics, and nutritional status were assessed at baseline, after 12 weeks, and after 24 weeks of intervention. Both groups improved physical function and nutritional status and increased physical activity after 12 weeks of intervention (paired student’s t-test, p < 0.01), and maintained the positive effects during the following 12 weeks. No group-by-time interaction was observed in any of the studied variables using mixed-model ANOVA. Based on these findings, we determined that 6 weeks of a group-based exercise intervention caused similar functional and nutritional benefits to a longer group-based intervention of 12 weeks when both are continued at home until 24 weeks.

Health Benefits of β-Hydroxy-β-Methylbutyrate (HMB) Supplementation in Addition to Physical Exercise in Older Adults: A Systematic Review with Meta-Analysis.

Both regular exercise training and beta-hydroxy-beta-methylbutyrate (HMB) supplementation are shown as effective treatments to delay or reverse frailty and reduce cognitive impairment in older people. However, there is very little evidence on the true benefits of combining both strategies. The aim of this meta-analysis was to quantify the effects of exercise in addition to HMB supplementation, on physical and cognitive health in older adults. Data from 10 randomized controlled trials (RCTs) investigating the effect of HMB supplementation and physical function in adults aged 50 years or older were analyzed, involving 384 participants. Results showed that HMB supplementation in addition to physical exercise has no or fairly low impact in improving body composition, muscle strength, or physical performance in adults aged 50 to 80 years, compared to exercise alone. There is a gap of knowledge on the beneficial effects of HMB combined with exercise to preserve cognitive functions in aging and age-related neurodegenerative diseases. Future RCTs are needed to refine treatment choices combining HMB and exercises for older people in particular populations, ages, and health status. Specifically, interventions in older adults aged 80 years or older, with cognitive impairment, frailty, or limited mobility are required.