Integrating exercise and nutrition to combat frailty: a systematic review of multidomain interventions in aging populations.

BACKGROUND

Frailty is a common geriatric syndrome associated with increased disability, hospitalization, and mortality. Exercise, nutritional supplementation (including herbal supplements such as ginseng), and multidomain interventions have been investigated as strategies to improve frailty-related outcomes in older adults.

OBJECTIVE

To summarize randomized controlled trial evidence on the effects of exercise, nutritional, and multidomain interventions on frailty, muscle strength, and physical performance in older adults.

METHODS

A narrative systematic review of randomized controlled trials (RCTs) involving frail or pre-frail older adults was conducted. Interventions included exercise training, nutritional supplementation (e.g., protein, amino acids, vitamin D, and ginseng-containing nutritional strategies), and combined multidomain strategies. Outcomes included frailty status, gait speed, muscle strength, body composition, cognition, and quality of life.

RESULTS

Exercise-based interventions consistently improved muscle strength, gait speed, and frailty status. Nutritional supplementation alone showed modest and inconsistent benefits, mainly in undernourished or sarcopenic populations. Combined exercise and nutrition interventions generally produced greater improvements in muscle mass and strength than single interventions alone. Multidomain interventions incorporating exercise, nutrition, and cognitive training demonstrated additional benefits in physical and cognitive outcomes, although results varied across studies. Evidence for pharmacologic or anabolic adjuncts remained limited and inconsistent.

CONCLUSION

Exercise-based interventions, particularly multicomponent resistance and functional training, provide the most consistent benefits for frailty-related outcomes in older adults. Nutritional support may enhance exercise-induced improvements but is insufficient alone to reverse frailty. Multidomain interventions appear promising, though further large-scale standardized trials are needed to determine optimal intervention strategies and long-term effects.