Frailty Improvement in Older Adults: A Structured Summative Review of Resistance Training and Protein-Based Interventions

Authors

• Tyson K. Kay, University of LynchburgFollow

Abstract

The aging global population is expanding the number of adults living with frailty and sarcopenia, two of the most consequential yet modifiable syndromes of the older adult. Both drive falls, disability, hospitalization, and mortality, and both are managed largely in outpatient settings. Despite consensus that frailty is dynamic rather than fixed, primary care lacks a shared standard for identifying it, and clinicians vary widely in how they manage it once it is recognized. This review evaluated whether combined resistance training and protein supplementation produce greater improvements in grip strength, lean muscle mass, and gait speed than either intervention alone in community-dwelling adults aged 60 and older. The search was performed using PubMed, the Cochrane Library, the JAMA Network, and Google Scholar, with combined keywords and MeSH terms, and citation tracking. Of 347 records identified, 32 met inclusion criteria after screening. The combined intervention exceeded either component alone, though the incremental value of protein was unevenly distributed across outcomes. Protein was most reliable for lean muscle mass (standardized mean differences, 0.58 to 0.95), with the effect concentrated in adults whose habitual protein intake was 1.1 g/kg/day or less; added a small increment to strength and no measurable benefit to gait speed. The benefit was largest in adults already sarcopenic, frail, or mobility-limited and absent in healthy, well-nourished adults. Resistance training should serve as the primary intervention, with protein intake raised to 1.2 to 1.5 g/kg/day for individuals with established frailty or sarcopenia. This approach is consistent with existing international guidelines, whose uptake in primary care remains limited, and can be adopted by providers now.

Recommended Citation

Kay TK. Frailty Improvement in Older Adults: A Structured Summative Review of Resistance Training and Protein-Based Interventions. University of Lynchburg Doctoral Project Assignment Repository. 2026; 8(3).