A Narrative Review of Non-Pharmacological Strategies for Managing Sarcopenia in Older Adults with Cardiovascular and Metabolic Diseases

SIMPLE SUMMARY: This article explores the relationship between sarcopenia, cardiovascular disease and metabolic diseases. The authors suggest non-drug treatments such as exercise, dietary modifications and behavioural interventions as potential strategies to help older adults manage these conditions. This review highlights the importance of combining strength and aerobic training and adopting comprehensive nutritional strategies. Additionally, the authors propose integrating behavioural science to help people adopt these lifestyle changes. Further research is needed to determine the most effective treatments and ways to make these changes easier for people to adopt. Overall, a comprehensive approach is required to address sarcopenia in older adults with cardiovascular and metabolic diseases. ABSTRACT: This narrative review examines the mechanisms underlying the development of cardiovascular disease (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being and quality of life in older adults with sarcopenia and coexisting cardiovascular and metabolic diseases.