Physical exercise and sarcopenia in older people: an OrtoMed position paper
Antimo Moretti, Federica Tomaino, Marco Paoletta, Sara Liguori, Silvia Migliaccio, Angelo Di Iorio, Raffaello Pellegrino, Davide Donnarumma, Daniele Di Nunzio, Giuseppe Toro, Maria Luisa Brandi, Giovanni Iolascon
Sarcopenia, an age-related degenerative disorder, leads to reduced skeletal muscle mass and function, and it is associated with increased fall risk, mobility limitations, and higher mortality rates. With no approved pharmacological treatments available, physical exercise (in combination with an appropriate nutritional intervention) remains the primary approach for managing the condition. This paper reviews the evidence supporting exercise as a key treatment for sarcopenia, emphasizing the benefits of resistance, aerobic, balance, and flexibility exercises. Resistance exercise has been shown to improve muscle strength and mass, while aerobic exercise supports cardiovascular health and muscle endurance. Additionally, multimodal approaches combining exercise with nutritional interventions (such as administration of whey protein and vitamin D) have proven effective in patients with osteosarcopenia. Emerging research is highlighting molecular mechanisms, including a role for “exerkins”, signaling molecules released during physical activity, which enhance both muscle and overall health. The updated program described in this paper offers evidence-based recommendations for prescribing tailored physical activity to older adults with sarcopenia, stressing the importance of individualized exercise prescriptions based on patients’ comorbidities and fitness levels. The integration of various exercise modalities and nutritional support is critical to improving function and quality of life in this vulnerable population.
