1
|
Gutiérrez-Reguero H, Buendía-Romero Á, Franco-López F, Martínez-Cava A, Hernández-Belmonte A, Courel-Ibáñez J, Ara I, Alcazar J, Pallarés JG. Effects of multicomponent training and HMB supplementation on disability, cognitive and physical function in institutionalized older adults aged over 70 years: a cluster-randomized controlled trial. J Nutr Health Aging 2024; 28:100208. [PMID: 38489992 DOI: 10.1016/j.jnha.2024.100208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES To investigate the synergist effects of exercise and β-hydroxy β-methylbutyrate (HMB) supplementation on disability, cognitive and physical function, and muscle power in institutionalized older people. DESIGN Cluster-randomized controlled trial. PARTICIPANTS Seventy-two institutionalized older adults (age = 83 ± 10 years old; 63% women) were randomized in four groups: exercise plus placebo (EX), HMB supplementation, EX plus HMB supplementation (EX + HMB), and control (CT). INTERVENTION The exercising participants completed a 12-week tailored multicomponent exercise intervention (Vivifrail; 5 days/week of an individualized resistance, cardiovascular, balance and flexibility program), whereas the HMB groups received a drink containing 3 g/day of HMB. MEASUREMENTS Participants were assessed Pre and Post intervention for disability and cognitive function (validated questionnaires), physical function (short physical performance battery, SPPB), handgrip strength and sit-to-stand relative muscle power. Linear mixed-effect models were used to compare changes among groups. RESULTS Compared to baseline, both EX and EX + HMB improved cognitive function (+2.9 and +1.9 points; p < 0.001), SPPB score (+2.9 points and +2.4 points; p < 0.001) and relative muscle power (+0.64 and +0.48 W·kg-1; p < 0.001), while CT and HMB remained unchanged (p > 0.05). Significant between-group differences were noted between CT, EX and EX + HMB for cognitive function (p < 0.01), between CT and EX + HMB for physical function (p = 0.043), and between CT, EX and EX + HMB for relative muscle power (p < 0.001). CONCLUSION The Vivifrail exercise program was effective in improving cognitive and physical function, and muscle power in nursing home residents, while HMB supplementation did not provide additional benefits when combined with exercise. These results emphasize the importance of physical exercise interventions in very old people as an essential basis for improving their overall health and quality of life.
Collapse
Affiliation(s)
- Héctor Gutiérrez-Reguero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Ángel Buendía-Romero
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Francisco Franco-López
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | - Alejandro Martínez-Cava
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain
| | | | - Javier Courel-Ibáñez
- Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
| |
Collapse
|
2
|
Yang C, Song Y, Li T, Chen X, Zhou J, Pan Q, Jiang W, Wang M, Jia H. Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Older Adults with Sarcopenia: A Randomized, Double-Blind, Placebo-Controlled Study. J Nutr Health Aging 2023; 27:329-339. [PMID: 37248756 DOI: 10.1007/s12603-023-1911-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/24/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Sarcopenia is recognized as a major public health concern because of its association with several adverse health events. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation reportedly delays the loss of muscle mass and function; however, the effect of HMB on sarcopenia remains inconclusive. We aimed to evaluate the impact of HMB intervention on muscle strength, physical performance, body compositions, and inflammatory factors in older adults with sarcopenia. DESIGN Randomized, double-blind, placebo-controlled trial. SETTING AND PARTICIPANTS This study included subjects aged ≥60 years with sarcopenia which were assigned to the HMB group (HMBG, n=18) and the placebo group (PG, n=16). INTERVENTION The HMBG and PG were supplied with HMB and placebo products twice daily for 12 weeks, and both received resistance exercise training twice a week in 12 weeks. MEASUREMENTS Hand grip strength was selected as the primary outcome; gait speed, five-time chair stand test, body composition and inflammatory indicators were selected as the secondary outcomes. The differences in changes from baseline between the two groups were analyzed using the analysis of covariance(ANCOVA). RESULTS After the 12-week intervention, the HMBG demonstrated significantly greater improvements in handgrip strength (4.61(95%CI:2.93,6.28) kg, P<0.001), gait speed (0.11(95%CI:0.02,0.20)m/s, P=0.014), five-time chair stand test (-3.65 (95%CI:-5.72, -1.58)s, P=0.001), muscle quality (2.47(95%CI:1.15,3.80),kg.kg-1 P=0.001) and tumor necrosis factor-like weak inducer of apoptosis (-15.23(95%CI:-29.80,-0.66)pmol/mL, P=0.041) compared with the PG; no significant differences in skeletal muscle mass, skeletal muscle index, and other body composition parameters were found between the two groups. CONCLUSION In older adults with sarcopenia, HMB significantly enhance the effect of resistance exercise training on muscle strength, physical performance, muscle quality, and reduced inflammatory factors. Therefore, HMB supplementation could be an effective treatment for sarcorpenia. The trial protocol was registered at http://www.chictr.org.cn/showproj.aspx?proj=47571 as ChiCTR2000028778.
Collapse
Affiliation(s)
- C Yang
- Hong Jia, School of Public Health, Southwest Medical University, Luzhou City, Sichuan Province, China,
| | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Kositsawat J, Duque G, Kirk B. Nutrients with anabolic/anticatabolic, antioxidant, and anti-inflammatory properties: Targeting the biological mechanisms of aging to support musculoskeletal health. Exp Gerontol 2021; 154:111521. [PMID: 34428477 DOI: 10.1016/j.exger.2021.111521] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/12/2021] [Accepted: 08/15/2021] [Indexed: 12/25/2022]
Abstract
Old age is associated with declines in bone density and muscle mass and function, which predisposes to mobility disability, falls, and fractures. Poor nutritional status, a risk factor for several age-related pathologies, becomes prevalent in old age and contributes to the structural and functional changes of the musculoskeletal system that increases the risk of osteoporosis, sarcopenia, osteosarcopenia, and physical frailty. The biological mechanisms underpinning these pathologies often overlap and include loss of proteostasis, impaired redox functioning, and chronic low-grade inflammation. Thus, provision of nutrients with anabolic/anticatabolic, antioxidant, and anti-inflammatory properties may be an effective strategy to offset these age-related pathologies. We searched PUBMED for pre-clinical and clinical work examining the effects of nutrients with a combined effect on muscle and bone. This review summarizes recent evidence on the mechanisms of action and potential clinical use of nutrients that concomitantly improve muscle and bone health in older persons.
Collapse
Affiliation(s)
- Jatupol Kositsawat
- Center on Aging, University of Connecticut Health Center, Farmington, CT, USA
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC 3021, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC 3021, Australia
| | - Ben Kirk
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC 3021, Australia; Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, St Albans, VIC 3021, Australia.
| |
Collapse
|
4
|
Buendía-Romero Á, Hernández-Belmonte A, Martínez-Cava A, García-Conesa S, Franco-López F, Conesa-Ros E, Courel-Ibáñez J. Isometric knee extension test: A practical, repeatable, and suitable tool for lower-limb screening among institutionalized older adults. Exp Gerontol 2021; 155:111575. [PMID: 34582970 DOI: 10.1016/j.exger.2021.111575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 09/22/2021] [Indexed: 12/13/2022]
Abstract
We aimed to analyze the isometric knee extension test (IKE) test in terms of i) intra- and inter-session repeatability, and ii) relationship with functional and body composition factors of sarcopenia among institutionalized older adults. Thirteen institutionalized older adults (age = 87 ± 10 years, body mass [BM] = 73.1 ± 10.9 kg, body mass index [BMI] = 28.5 ± 3.8 kg·m2) were recruited from a nursing home. Variability of maximal isometric force registered in three IKE trials performed on the same day was used to examine intra-session repeatability, whereas inter-session repeatability was analyzed by comparing maximal isometric force from two different days. Furthermore, functional (Handgrip, 6-m Gait Speed, Time Up and Go [TUG], and Sit-to-stand tests) and body composition (appendicular lean mass adjusted by BMI, ALM/BMI) evaluations were conducted. Statistics included the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM), expressed in both absolute (N·kg-1) and relative terms (coefficient of variation, CV = 100 × SEM / mean). High to very high intra-session repeatability was found for both the dominant and non-dominant legs (CV ≤ 6.0%, ICC ≥ 0.989). Similarly, both legs showed high inter-session repeatability (SEM ≤ 0.26 N·kg-1, ICC ≥ 0.959). On the other hand, significant relationships were found between Dominant and Non-dominant IKE tests and 6-m Gait Speed (r = 0.77; r = 0.58), ALM/BMI (r = 0.62; r = 0.58), and Non-dominant Handgrip/BM (r = 0.60; r = 0.68). In addition, a significant association was found between Dominant IKE/BM and TUG (r = -0.74), as well as between Non-dominant IKE/BM and Dominant Handgrip/BM (r = 0.67). These findings suggest that the IKE test is a repeatable and suitable strategy for lower-limb screening in institutionalized older adults.
Collapse
Affiliation(s)
- Ángel Buendía-Romero
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Alejandro Hernández-Belmonte
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Alejandro Martínez-Cava
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Silverio García-Conesa
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Francisco Franco-López
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Elena Conesa-Ros
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain)
| | - Javier Courel-Ibáñez
- Faculty of Sport Sciences, Human Performance and Sports Science Laboratory, University of Murcia, Murcia, (Spain).
| |
Collapse
|
5
|
Gala K, Desai V, Liu N, Omer EM, McClave SA. How to Increase Muscle Mass in Critically Ill Patients: Lessons Learned from Athletes and Bodybuilders. Curr Nutr Rep 2021; 9:369-380. [PMID: 33098051 DOI: 10.1007/s13668-020-00334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Decades of research on nutrition and exercise on athletes and bodybuilders has yielded various strategies to promote anabolism and improve muscle health and growth. We reviewed these interventions in the context of muscle loss in critically ill patients. RECENT FINDINGS For critically ill patients, ensuring optimum protein intake is important, potentially using a whey-containing source and supplemented with vitamin D and leucine. Agents like hydroxyl β-methylbutyrate and creatine can be used to promote muscle synthesis. Polyunsaturated fatty acids stimulate muscle production as well as have anti-inflammatory properties that may be useful in critical illness. Adjuncts like oxandralone promote anabolism. Resistance training has shown mixed results in the ICU setting but needs to be explored further with specific outcomes. Critically ill patients suffer from severe proteolysis during hospitalization as well as persistent inflammation, immunosuppression, and catabolism syndrome after discharge. High protein supplementation, ergogenic aids, anti-inflammatories, and anabolic adjuncts have shown potential in alleviating muscle loss and should be used in intensive care units to optimize patient recovery.
Collapse
Affiliation(s)
- Khushboo Gala
- Department of Internal Medicine, University of Louisville, 550 S Jackson Street, 3rd Floor, Ambulatory Care Building, Louisville, KY, 40202, USA.
| | - Viral Desai
- Department of Internal Medicine, University of Louisville, 550 S Jackson Street, 3rd Floor, Ambulatory Care Building, Louisville, KY, 40202, USA
| | - Nanlong Liu
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
| | - Endashaw M Omer
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
| | - Stephen A McClave
- Department of Gastroenterology and Hepatology, University of Louisville, Louisville, KY, USA
| |
Collapse
|
6
|
Courel-Ibáñez J, Buendía-Romero Á, Pallarés JG, García-Conesa S, Martínez-Cava A, Izquierdo M. Impact of Tailored Multicomponent Exercise for Prevent Weakness and Falls on Nursing Home Residents' Functional Capacity. J Am Med Dir Assoc 2021; 23:98-104.e3. [PMID: 34197791 DOI: 10.1016/j.jamda.2021.05.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We aimed to determine whether the benefits of long (24 weeks) and short (4 weeks) training programs persisted after short (6 weeks) and long (14 weeks) periods of inactivity in older adult nursing home residents with sarcopenia. DESIGN Multicenter randomized trial. INTERVENTION The Vivifrail tailored, multicomponent exercise program (http://vivifrail.com) was conducted to individually prescribe exercise for frail older adults, depending on their functional capacity. The training included 4 levels combining strength and power, balance, flexibility, and cardiovascular endurance exercises. SETTING AND PARTICIPANTS Twenty-four institutionalized older adults (87.1 ± 7.1 years, 58.3% women) diagnosed with sarcopenia were allocated into 2 groups: the Long Training-Short Detraining (LT-SD) group completed 24 weeks of supervised Vivifrail training followed by 6 weeks of detraining; the Short Training-Long Detraining (ST-LD) group completed 4 weeks of training and 14 weeks of detraining. MEASURES Changes in functional capacity and strength were evaluated at baseline, and after short and long training and detraining periods. RESULTS Benefits after short and long exercise interventions persisted when compared with baseline. Vivifrail training was highly effective in the short term (4 weeks) in increasing functional and strength performance (effect size = 0.32-1.44, P < .044) with the exception of handgrip strength. Continued training during 24 weeks produced 10% to 20% additional improvements (P < .036). Frailty status was reversed in 36% of participants, with 59% achieving high self-autonomy. Detraining resulted in a 10% to 25% loss of strength and functional capacity even after 24 weeks of training (effects size = 0.24-0.92, P < .039). CONCLUSIONS AND IMPLICATIONS Intermittent strategies such as 4 weeks of supervised exercise 3 times yearly with no more than 14 weeks of inactivity between exercise periods appears as an efficient solution to the global challenge of maintaining functional capacity and can even reverse frailty in vulnerable institutionalized older adults.
Collapse
Affiliation(s)
- Javier Courel-Ibáñez
- Human Performance and Sports Science Laboratory, University of Murcia, Murcia, Spain.
| | - Ángel Buendía-Romero
- Human Performance and Sports Science Laboratory, University of Murcia, Murcia, Spain.
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, University of Murcia, Murcia, Spain
| | | | | | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
7
|
Bear DE, Cruz-Jentoft AJ, Stout JR. β-hydroxy-β-methylbutyrate supplementation in older persons - an update. Curr Opin Clin Nutr Metab Care 2021; 24:48-52. [PMID: 33148945 DOI: 10.1097/mco.0000000000000713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW The interest in the use of beta-hydroxy-beta-methylbutyrate (HMB) as an intervention to prevent and treat sarcopenia has increased over recent years. The purpose of this review is to explore recent evidence pertaining to the mechanism of action of HMB and how this may influence changes in lean mass and strength in older persons who are both hospitalized and living in the community. RECENT FINDINGS No new studies have been published over the last 2 years investigating the effect of HMB in older persons who are hospitalized, aside from one posthoc analysis of a randomized controlled trial exploring the effect of a high protein oral nutrition supplement containing HMB on handgrip strength and nutritional status. Three studies recruiting community-dwelling older adults have been published, but results are influenced by suboptimal methodological quality. SUMMARY Recent data suggest the need for high-quality studies investigating the effectiveness of HMB to improve outcomes related to sarcopenia in both hospitalized and community-dwelling older persons.
Collapse
Affiliation(s)
- Danielle E Bear
- Departments of Nutrition and Dietetics and Critical Care, Guy's and St Thomas' NHS Foundation Trust
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| | | | - Jeffrey R Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, Florida, USA
| |
Collapse
|
8
|
Courel-Ibáñez J, Pallarés JG, García-Conesa S, Buendía-Romero Á, Martínez-Cava A, Izquierdo M. Supervised Exercise (Vivifrail) Protects Institutionalized Older Adults Against Severe Functional Decline After 14 Weeks of COVID Confinement. J Am Med Dir Assoc 2020; 22:217-219.e2. [PMID: 33296679 PMCID: PMC7837301 DOI: 10.1016/j.jamda.2020.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Javier Courel-Ibáñez
- Faculty of Sport Sciences Human Performance and Sports Science Laboratory University of Murcia Murcia, Spain
| | - Jesús G Pallarés
- Faculty of Sport Sciences Human Performance and Sports Science Laboratory University of Murcia Murcia, Spain
| | - Silverio García-Conesa
- Faculty of Sport Sciences Human Performance and Sports Science Laboratory University of Murcia Murcia, Spain
| | - Ángel Buendía-Romero
- Faculty of Sport Sciences Human Performance and Sports Science Laboratory University of Murcia Murcia, Spain
| | - Alejandro Martínez-Cava
- Faculty of Sport Sciences Human Performance and Sports Science Laboratory University of Murcia Murcia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES) Instituto de Salud Carlos III Madrid, Spain.
| |
Collapse
|
9
|
Courel-Ibáñez J, Vetrovsky T, Dadova K, Pallarés JG, Steffl M. Health Benefits of β-Hydroxy-β-Methylbutyrate (HMB) Supplementation in Addition to Physical Exercise in Older Adults: A Systematic Review with Meta-Analysis. Nutrients 2019; 11:nu11092082. [PMID: 31484462 PMCID: PMC6769498 DOI: 10.3390/nu11092082] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 12/14/2022] Open
Abstract
Both regular exercise training and beta-hydroxy-beta-methylbutyrate (HMB) supplementation are shown as effective treatments to delay or reverse frailty and reduce cognitive impairment in older people. However, there is very little evidence on the true benefits of combining both strategies. The aim of this meta-analysis was to quantify the effects of exercise in addition to HMB supplementation, on physical and cognitive health in older adults. Data from 10 randomized controlled trials (RCTs) investigating the effect of HMB supplementation and physical function in adults aged 50 years or older were analyzed, involving 384 participants. Results showed that HMB supplementation in addition to physical exercise has no or fairly low impact in improving body composition, muscle strength, or physical performance in adults aged 50 to 80 years, compared to exercise alone. There is a gap of knowledge on the beneficial effects of HMB combined with exercise to preserve cognitive functions in aging and age-related neurodegenerative diseases. Future RCTs are needed to refine treatment choices combining HMB and exercises for older people in particular populations, ages, and health status. Specifically, interventions in older adults aged 80 years or older, with cognitive impairment, frailty, or limited mobility are required.
Collapse
Affiliation(s)
- Javier Courel-Ibáñez
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30100 Murcia, Spain.
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague 16252, Czech Republic
| | - Klara Dadova
- Faculty of Physical Education and Sport, Charles University, Prague 16252, Czech Republic
| | - Jesús G Pallarés
- Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, 30100 Murcia, Spain
| | - Michal Steffl
- Faculty of Physical Education and Sport, Charles University, Prague 16252, Czech Republic
| |
Collapse
|