The evidence and impact of deprescribing on sarcopenia parameters: a systematic review
Abstract Background Polypharmacy (concomitant prescription of ≥ 5 medications) affects a third of older people, and evidence suggests an association with sarcopenia (loss of skeletal muscle mass/quality, muscle strength, and/or physical performance). As such, deprescribing has been recommended in ro...
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BMC
2025-03-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-05819-7 |
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| author | Kinda Ibrahim Natalie J. Cox Stephen E. R. Lim Eloise Radcliffe Carina Lundby Konstantinos Prokopidis Wade Thompson Frank Moriarty |
| author_facet | Kinda Ibrahim Natalie J. Cox Stephen E. R. Lim Eloise Radcliffe Carina Lundby Konstantinos Prokopidis Wade Thompson Frank Moriarty |
| author_sort | Kinda Ibrahim |
| collection | DOAJ |
| description | Abstract Background Polypharmacy (concomitant prescription of ≥ 5 medications) affects a third of older people, and evidence suggests an association with sarcopenia (loss of skeletal muscle mass/quality, muscle strength, and/or physical performance). As such, deprescribing has been recommended in routine management of sarcopenia, however it’s unknown whether deprescribing is beneficial. This systematic review aimed to understand effects of deprescribing on sarcopenia parameters in older adults. Methods Medline, Embase, CINAHL, Web of Science, and the Cochrane Library databases were searched up to July 2023. All studies reporting effects of deprescribing interventions on sarcopenia parameters (primary outcomes) or nutritional intake (secondary outcomes) among older adults were included. Findings were summarised narratively, and study quality was assessed. Results A total of 4860 articles were identified and six were included (mean age range 67–87 years). Studies were heterogeneous in design, settings, follow-up periods, and outcomes. Deprescribing had no effect on skeletal muscle mass (n = 2). Positive effects were shown on handgrip strength with two studies reporting improvements following antihypertensive or benzodiazepines discontinuation and one showing no change between admission and discharge with general deprescribing. Outcomes of deprescribing on physical function outcomes varied based on the measures used. For example, one study showed no changes in timed up and go, Whereas effects on gait speed was contradictory in two studies, with preservation and deterioration reported. Two studies reported improvement between baseline and follow up in balance scores measured part of the Short physical performance battery or using the Short Berg’s Balance Scale among those who discontinued antihypertensive and/or benzodiazepines. Two studies reported improvements in nutritional outcomes following deprescribing at hospital discharge, whereas two other studies reported no change or increase in weight loss. Conclusion There is limited research about the impact of deprescribing on sarcopenia parameters. This systematic review found no significant changes in muscle mass but there is some evidence in improvements in strength, physical performance, and nutritional status with deprescribing. The multidisciplinary implementation of nutrition and exercise therapies, as well as medication management to modify polypharmacy, may further promote improvement in sarcopenia. However, more high-quality research is needed to understand the effects of deprescribing on sarcopenia parameters among older people including those with confirmed diagnosis of sarcopenia. Registration The review was registered on the international prospective register of systematic reviews (PROSPERO, CRD42023417997). |
| format | Article |
| id | doaj-art-43d66215146f4ebbb33d05f42fdc5197 |
| institution | DOAJ |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj-art-43d66215146f4ebbb33d05f42fdc51972025-08-20T03:05:48ZengBMCBMC Geriatrics1471-23182025-03-0125111110.1186/s12877-025-05819-7The evidence and impact of deprescribing on sarcopenia parameters: a systematic reviewKinda Ibrahim0Natalie J. Cox1Stephen E. R. Lim2Eloise Radcliffe3Carina Lundby4Konstantinos Prokopidis5Wade Thompson6Frank Moriarty7School of Primary Care, Population Sciences and Medical Education, Primary Care Research Centre and the NIHR Applied Research Collaboration (ARC) Wessex, University of SouthamptonAcademic Geriatric Medicine, Human Development and Health, Faculty of Medicine, NIHR Applied Research Collaboration (ARC) Wessex, University of SouthamptonAcademic Geriatric Medicine, Human Development and Health, Faculty of Medicine, NIHR Applied Research Collaboration (ARC) Wessex, University of SouthamptonSchool of Primary Care, Population Sciences and Medical Education, Primary Care Research Centre and the NIHR Applied Research Collaboration (ARC) Wessex, University of SouthamptonClinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark and Hospital Pharmacy Funen, Odense University HospitalDepartment of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences, University of LiverpoolDepartment of Anaesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British ColumbiaSchool of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health SciencesAbstract Background Polypharmacy (concomitant prescription of ≥ 5 medications) affects a third of older people, and evidence suggests an association with sarcopenia (loss of skeletal muscle mass/quality, muscle strength, and/or physical performance). As such, deprescribing has been recommended in routine management of sarcopenia, however it’s unknown whether deprescribing is beneficial. This systematic review aimed to understand effects of deprescribing on sarcopenia parameters in older adults. Methods Medline, Embase, CINAHL, Web of Science, and the Cochrane Library databases were searched up to July 2023. All studies reporting effects of deprescribing interventions on sarcopenia parameters (primary outcomes) or nutritional intake (secondary outcomes) among older adults were included. Findings were summarised narratively, and study quality was assessed. Results A total of 4860 articles were identified and six were included (mean age range 67–87 years). Studies were heterogeneous in design, settings, follow-up periods, and outcomes. Deprescribing had no effect on skeletal muscle mass (n = 2). Positive effects were shown on handgrip strength with two studies reporting improvements following antihypertensive or benzodiazepines discontinuation and one showing no change between admission and discharge with general deprescribing. Outcomes of deprescribing on physical function outcomes varied based on the measures used. For example, one study showed no changes in timed up and go, Whereas effects on gait speed was contradictory in two studies, with preservation and deterioration reported. Two studies reported improvement between baseline and follow up in balance scores measured part of the Short physical performance battery or using the Short Berg’s Balance Scale among those who discontinued antihypertensive and/or benzodiazepines. Two studies reported improvements in nutritional outcomes following deprescribing at hospital discharge, whereas two other studies reported no change or increase in weight loss. Conclusion There is limited research about the impact of deprescribing on sarcopenia parameters. This systematic review found no significant changes in muscle mass but there is some evidence in improvements in strength, physical performance, and nutritional status with deprescribing. The multidisciplinary implementation of nutrition and exercise therapies, as well as medication management to modify polypharmacy, may further promote improvement in sarcopenia. However, more high-quality research is needed to understand the effects of deprescribing on sarcopenia parameters among older people including those with confirmed diagnosis of sarcopenia. Registration The review was registered on the international prospective register of systematic reviews (PROSPERO, CRD42023417997).https://doi.org/10.1186/s12877-025-05819-7SarcopeniaDeprescribingMuscle strengthMuscle massMuscle functionOutcomes |
| spellingShingle | Kinda Ibrahim Natalie J. Cox Stephen E. R. Lim Eloise Radcliffe Carina Lundby Konstantinos Prokopidis Wade Thompson Frank Moriarty The evidence and impact of deprescribing on sarcopenia parameters: a systematic review BMC Geriatrics Sarcopenia Deprescribing Muscle strength Muscle mass Muscle function Outcomes |
| title | The evidence and impact of deprescribing on sarcopenia parameters: a systematic review |
| title_full | The evidence and impact of deprescribing on sarcopenia parameters: a systematic review |
| title_fullStr | The evidence and impact of deprescribing on sarcopenia parameters: a systematic review |
| title_full_unstemmed | The evidence and impact of deprescribing on sarcopenia parameters: a systematic review |
| title_short | The evidence and impact of deprescribing on sarcopenia parameters: a systematic review |
| title_sort | evidence and impact of deprescribing on sarcopenia parameters a systematic review |
| topic | Sarcopenia Deprescribing Muscle strength Muscle mass Muscle function Outcomes |
| url | https://doi.org/10.1186/s12877-025-05819-7 |
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