Nutritional and Pharmacological Interventions for Sarcopenia in Older Adults: A Systematic Review and Network Meta-Analysis.

Multinutrition, protein, and protein with vitamin D probably improve quality of life compared with usual care.

• Multinutrition: SMD 0.65 (95% CI, 0.04–1.26), moderate certainty evidence
• Protein alone: SMD 0.77 (95% CI, 0.38–1.17), moderate certainty evidence
• Protein with vitamin D: SMD 0.37 (95% CI, 0.03–0.72), moderate certainty evidence
• All comparisons were against usual care in older adults with sarcopenia

Protein combined with vitamin D probably enhances handgrip strength, and multinutrition may improve handgrip strength.

• Protein and vitamin D combination: MD 2.07 kg (95% CI, 0.91–3.23), moderate certainty evidence
• Multinutrition: MD 2.32 kg (95% CI, 0.85–3.79), low certainty evidence
• Comparisons were made against usual care

Pharmacological interventions did not yield significant improvements in handgrip strength, knee extension strength, or timed up and go tests.

• Handgrip strength: MD 1.72 kg (95% CI, -0.74 to 4.18), not significant
• Knee extension strength: SMD 0.49 (95% CI, -0.05 to 1.03), not significant
• Timed up and go test: MD 0.06 (95% CI, -0.98 to 1.11), not significant
• Despite lack of functional improvements, pharmacological therapy may increase muscle mass

The systematic review and network meta-analysis included 59 RCTs with a total of 5543 participants after screening 12,308 articles.

• Electronic databases searched included Embase, MEDLINE, Cochrane Central Registry of Controlled Trials, Web of Science, and CINAHL, up to April 2022
• Only randomized controlled trials (RCTs) examining nutritional and pharmacological interventions were included
• Participants were older adults with sarcopenia in any setting
• Frequent random-effects network meta-analyses were used to synthesize evidence
• The GRADE framework was used to assess certainty of evidence

Pharmacological therapy may increase muscle mass in older adults with sarcopenia despite lack of significant functional improvements.

• This finding was rated as lower certainty compared to the moderate-certainty findings for nutritional interventions
• The conclusion was drawn from the network meta-analysis of included RCTs
• Specific muscle mass effect sizes for pharmacological interventions were not reported in the abstract