Mapping the global landscape of behavioral interventions for sarcopenia in older adults: implications for clinical practice and research prioritization

Sarcopenia is a significant health challenge for older adults. Behavioral interventions offer promising, accessible strategies, but the evidence base requires a comprehensive assessment. This study aimed to map the global landscape of clinical trials on behavioral interventions for sarcopenia, analyzing trial characteristics, geographic trends, and the translation of completed trials into publications. A systematic review of trials registered on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) was conducted for trials registered up to 1 September 2024. Trials investigating non-pharmacological behavioral strategies for sarcopenia in adults ≥ 60 years were included. Data on design, sponsorship, location, and publication status were extracted and analyzed. Among 171 identified trials, exercise training dominated (67.8%), with multicomponent and resistance training being the primary subtypes. Trials were concentrated in Asia (45.0%) and Europe (21.6%). Most were sponsored by academia (59.1%), enrolled ≤ 100 participants (73.1%), and used randomized designs (84.8%). Only 27 of 52 completed trials (51.9%) were published, with a median publication time of 14.5 months. The cumulative publication rate was 51.9% at 3 years post-completion. The research landscape is active but exhibits a pronounced focus on exercise, underrepresentation of other behavioral strategies, and significant delays in result dissemination. Coordinated efforts are needed to diversify interventions, ensure global representativeness, and improve the timely publication of findings to inform clinical practice.