Synergistic effects of multicomponent exercise and rTMS on sarcopenia and mild cognitive impairment in older people:
Yanqing Ren1,2, Xiangfeng He1, Zhen Zhang1
1Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Background:
Sarcopenia and cognitive impairment (CI) are major contributors to disability in older people, significantly reducing quality of life and imposing a substantial burden on healthcare systems. Sarcopenia accelerates cognitive decline through mechanisms such as chronic inflammation, mitochondrial dysfunction, and disruption of the muscle-brain axis. Conversely, CI impairs motor planning and daily functioning, further exacerbating muscle loss and physical deterioration. Previous studies have shown that physical exercise optimizes peripheral physiological conditions, promoting neuroplasticity in the central nervous system. Similarly, repetitive transcranial magnetic stimulation (rTMS) enhances brain plasticity, improving both cognitive and physical functions. This study aims to evaluate the combined effects of multicomponent exercise and rTMS on sarcopenia and CI in older people.
Methods:
This is a 16-week, randomized, single-blind, controlled trial. A total of 51 older people with sarcopenia and mild cognitive impairment (MCI) will be randomly assigned to one of three groups: (1) exercise combined with rTMS, (2) exercise combined with sham rTMS, and (3) a control group. The exercise intervention will integrate Baduanjin and resistance training, while rTMS will target the dorsolateral prefrontal cortex (DLPFC). Participants will be assessed for muscle fitness, cognitive function, and psychological well-being at baseline, week 8, and week 16.
Discussion:
This trial aims to provide empirical evidence on the synergistic effects of exercise and rTMS in managing sarcopenia and MCI in older people. Additionally, it will explore the neural mechanisms underlying improvements in cognitive function. The findings may inform integrated treatment strategies for these interconnected conditions, enhancing quality of life and promoting functional independence in aging populations.
Trial Registration:
International Traditional Medicine Clinical Trial Registry, ITMCTR2025000311. Registered 17 February 2025.
