EffectS of Lifestyle Interventions in Older PEople With Obesity (Effective SLOPE): a Systematic Review With Network Meta-Analyses.
Gabriel Torbahn, Daniel Schoene, Isabel Galicia Ernst et al.
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In 30 seconds
This systematic review and network meta-analysis assessed lifestyle interventions for community-dwelling older adults with obesity, drawing on randomized controlled trials lasting at least 12 weeks. The review included 72 trials (6,716 participants) in descriptive summaries and 54 trials (4,249 participants) in network meta-analyses. Combining nutrition, exercise, and behavior change improved physical function versus control (SMD 3.37 [1.76;4.97]), with high-certainty evidence. The combined approach may also reduce body and fat mass, but evidence for these outcomes was very uncertain; data on quality of life, psychosocial outcomes, and health events were insufficient or heterogeneous.
Key findings
- Nutrition, exercise, and behavior change improved physical function versus control (SMD 3.37 [1.76;4.97]; high-certainty evidence).
- The combined intervention may reduce body mass (MD -8.69 [-13.14;-4.25]) and fat mass (MD -6.58 [-10.44;-2.73]); evidence was very uncertain.
- Estimated effects on fat-free mass (MD -1.38 [-3.52;0.76]) and bone mineral density (MD -0.01 [-0.05;0.02]) did not indicate clear reductions.
- Evidence was insufficient or too heterogeneous for clear conclusions about quality of life, psychosocial outcomes, and health events.
Why it matters
Obesity management in older adults needs to consider physical function as well as changes in body composition. This review suggests that combining nutrition, exercise, and behavior change can improve physical function, while the evidence for other outcomes remains less certain. The findings also highlight gaps in patient-relevant outcomes and in evidence for frail populations.
What to keep in mind
Evidence for body-composition outcomes was very uncertain, and data on quality of life, psychosocial outcomes, and health events were insufficient or heterogeneous. The authors call for further trials, particularly in frail populations and on patient-relevant outcomes.