Obesity causes frailty in older adults.
However, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia.
In this clinical trial involving 160 obese older adults, Dr Dennis Villareal and colleagues evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss.
Participants were randomly assigned to a weight-management program plus 1 of 3 exercise programs — aerobic training, resistance training, or combined aerobic and resistance training — or to a control group.
The team's primary outcome was the change in Physical Performance Test score from baseline to 6 months.
Secondary outcomes included changes in other frailty measures, body composition, bone mineral density, and physical functions.
|Body weight decreased by 9% in all exercise groups|
|New England Journal of Medicine|
A total of 141 participants completed the study.
The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups.
The research team found that the scores increased more in all exercise groups than in the control group.
Peak oxygen consumption increased more in the combination and aerobic groups, than in the resistance group.
The team noted that strength increased more in the combination and resistance groups than in the aerobic group.
The researchers found that body weight decreased by 9% in all exercise groups but did not change significantly in the control group.
Lean mass decreased less in the combination and resistance groups than in the aerobic group, as did bone mineral density at the total hip.
The team observed that exercise-related adverse events included musculoskeletal injuries.
Dr Villareal's team commented, "Of the methods tested, weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults."