Given the extensive body of evidence on exercise for preventing the onset and progression of sarcopenia, and the many systematic reviews, meta-analyses, and randomized controlled trials (RCTs), a comprehensive literature search method for systematic reviews and meta-analyses was employed in this HQ. This review examined the effects and significance of resistance training and combined (multi-component) exercise, including resistance training, on preventing the onset and progression of sarcopenia in older adults. Nine systematic reviews and meta-analyses of studies that were included in the umbrella review and examined the effects of exercise interventions on older adults, including older adults with sarcopenia, were extracted (Figures 1 and 2) 1-10. Five of these nine studies were systematic reviews or meta-analyses of older adults with pre-sarcopenia or sarcopenia. The exercise interventions included resistance training alone or combined resistance training with balance exercise, aerobic exercise, and gait training. In these five studies, one of the outcomes, including muscle mass (skeletal muscle mass index SMI, lean muscle mass), muscle strength (grip strength, knee extension strength), and physical function (gait speed, timed up and go test TUG, short physical performance battery SPPB), was significantly improved. For four of the nine studies 7-10, the subjects were older people living in the community, and either resistance training alone or combined resistance training with aerobic exercise, balance exercise, gait training, and training of activity of daily living (ADL) significantly improved muscle strength, physical function, and balance ability, respectively. The duration of exercise intervention in these studies ranged from 4 to 120 weeks. No consistent conclusions were obtained regarding the frequency or intensity of exercise interventions. Five of the nine studies adopted in the umbrella review were for older adults with low muscle mass or sarcopenia, and also showed the effectiveness of exercise interventions as sarcopenia prevention for community-dwelling older adults. Therefore, resistance training alone or multicomponent exercise, including resistance training, was strongly recommended to prevent the onset and progression of sarcopenia in older adults. No adverse events were reported in the included studies. The papers have suggested that exercise might be effective in improving muscle strength and physical function, as well as in maintaining and improving ADLs, and the disadvantages related to cost were thought to be small, further leading to more benefits than harms. Citizen representatives participated in the healthcare question formulation meetings and the vote to decide on recommendations, and the recommendations were formulated based on their wishes as much as possible. The recommendation that resistance training alone and multi-component exercise are effective in preventing the onset and progression of sarcopenia is expected to have a positive impact on patients, the public, and society, and may provide an opportunity to introduce or intensify exercise or receive exercise instruction. It is expected that high-quality evidence will be developed that also takes into account generational and sex differences, including research on effective exercise content and combinations of exercise and nutrition for preventing the onset and progression of sarcopenia in older adults. This document is the official English translation of the Japanese version published by the Japanese Association for Sarcopenia and Frailty and the National Center for Geriatrics and Gerontology in March 2025 1. This work was supported by the Japan Agency for Medical Research and Development (AMED) under the project “Project for Establishing Research and Development Infrastructure for the Social Implementation of Prevention and Health Promotion/Healthcare Social Implementation Infrastructure Development Project” (Management No. JP22rea522005). S.O. has disclosed financial relationships with Daiichi Sankyo Co. Ltd., and Tanabe Mitsubishi Pharma Corporation. M.A. has disclosed financial relationships with Daiichi Sankyo Co. Ltd., MSD K.K. Toa Eiyo Co. Ltd., Towa Pharmaceutical Co. Ltd., Eisai Co. Ltd., Kracie Pharmaceutical Co. Ltd., Tsumura Pharmaceutical Co. Ltd., Tanabe Mitsubishi Pharma Corporation, Chugai Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd., Astellas Pharma Inc., Bayer Yakuhin Ltd. The other authors declare no conflicts of interest.
Ogawa et al. (Wed,) studied this question.