Combining exercise, nutrition, and brain training cuts functional decline in older adults
A comprehensive analysis of 38 clinical trials shows that multidomain interventions—combining physical activity, cognitive training, and nutritional support—significantly improve mobility and mental function in people over 60. The findings could reshape how healthcare systems and insurers approach aging-related care, potentially reducing costly hospitalizations and long-term care costs.
Originaltitel: Effects of multidomain interventions on health outcomes in older adults: A systematic review and meta-analysis
BACKGROUND: With rising global aging, healthcare systems face challenges from multimorbidity, functional decline, and cognitive impairment. Multidomain interventions offer a promising approach to promoting healthy aging. This systematic review and meta-analysis evaluated the effects of multidomain interventions (≥3 domains) on motor-functional, cognitive, and psychological outcomes in older adults without moderate/severe dementia. METHODS: Following PRISMA guidelines, PubMed and Embase were searched up to April 30, 2024. Eligible studies included clinical trials or observational studies involving adults ≥60 years receiving multidomain interventions versus control/standard care. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. RESULTS: Thirty-eight studies (57 comparisons) were included (median age: 75.3 intervention, 75.1 control; >60% female). Intervention lasted 2-36 months (median 6.0). All studies targeted the physical domain, 78.9% cognitive, 81.6% nutritional, and 84.2% additional domains. Motor-functional outcomes improved significantly (e.g., Short Physical Performance Battery: SMD = 0.40, 95% CI 0.14 to 0.66; Cardiovascular Health Study frailty criteria: SMD = -0.14, 95% CI -0.23 to -0.05), with diminishing effects over time. Other indicators (e.g., handgrip strength), showed modest improvements. Cognitive improvements were limited to Montreal Cognitive Assessment (MoCA; SMD = 0.23, 95% CI 0.06 to 0.40). Psychological benefits included reduced depressive symptoms (Geriatric Depression Scale: SMD = -0.35, 95% CI -0.57 to -0.12). Effect estimates for Timed Up and Go and RBANS were attenuated in sensitivity analysis excluding high-risk-of-bias studies. CONCLUSIONS: Multidomain interventions improve motor-functional and psychological well-being. Moderate cognitive benefits are observed primarily using the MoCA. These findings support large-scale implementation in geriatric care and highlight the need for strategies to sustain long-term effectiveness.