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Sex Differences in Adaptations in Muscle Strength and Size Following Resistance Training in Older Adults: A Systematic Review and Meta-analysis

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Abstract

Background

Reductions in muscle size and strength occur with aging. These changes can be mitigated by participation in resistance training. At present, it is unknown if sex contributes to differences in adaptation to resistance training in older adults.

Objective

The aim of this systematic review was to determine if sex differences are apparent in adaptations to resistance training in older adults.

Design

Systematic review with meta-analysis.

Data Sources

Web of Science; Science Direct; SPORTDiscus; CINAHL; and MEDLINE were searched from inception to June 2020.

Eligibility Criteria

Studies where males and females older than 50 years of age performed identical resistance training interventions and had outcome measures of muscle strength or size.

Results

We initially screened 5337 studies. 30 studies (with 41 comparison groups) were included in our review (1410 participants; 651 males, 759 females). Mean study quality was 14.7/29 on a modified Downs and Black checklist, considered moderate quality. Females gained more relative lower-body strength than males (g = − 0.21 [95% CI − 0.33, − 0.10], p = 0.0003) but there were no differences in relative change for upper-body strength (g = − 0.29 [95% CI − 0.62, 0.04], p = 0.08) or relative muscle size (g = 0.10 [95% CI − 0.04, 0.23], p = 0.16). Males gained more absolute upper-body strength (g = 0.48 [95% CI 0.09, 0.88], p = 0.016), absolute lower-body strength (g = 0.33 [95% CI 0.19, 0.47], p < 0.0001), and absolute muscle size (g = 0.45 [95% CI 0.23, 0.66], p < 0.0001).

Conclusion

Our results indicate that sex differences in adaptations to resistance training are apparent in older adults. However, it is evident that the interpretation of sex-dependent adaptations to resistance training is heavily influenced by the presentation of the results in either an absolute or relative context.

Study Registration

Open Science Framework (osf.io/afn3y/).

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Author notes

  1. Matthew D. Jones and Michael A. Wewege equally contributed to the manuscript and are joint first authors.

Authors and Affiliations

  1. School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia

    Matthew D. Jones, Michael A. Wewege & Amanda D. Hagstrom

  2. Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia

    Matthew D. Jones & Michael A. Wewege

  3. Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia

    Daniel A. Hackett

  4. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia

    Justin W. L. Keogh

  5. Human Potential Centre, AUT University, Auckland, New Zealand

    Justin W. L. Keogh

  6. Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, QLD, Australia

    Justin W. L. Keogh

  7. Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

    Justin W. L. Keogh

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  1. Matthew D. Jones
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Correspondence to Amanda D. Hagstrom.

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Funding

Michael Wewege was supported by a University Postgraduate Award and a School of Medical Sciences Top-Up Scholarship from the University of New South Wales, and a Postgraduate Scholarship from the National Health and Medical Research Council of Australia. No other sources of funding were used to assist in the preparation of this article.

Conflict of interest

Matthew Jones, Michael Wewege, Daniel Hackett, Justin Keogh and Amanda Hagstrom declare that they have no conflicts of interest relevant to the content of this review.

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Data and code are available on the Open Science Framework (osf.io/afn3y).

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All data and analysis code will be available after publication on the Open Science Framework (osf.io/afn3y/).

Author contributions

ADH study design, literature search, and writing of the manuscript. MJ screening, study quality, results and methods manuscript writing. MW screening, statistical analysis, results. DH study quality. ADH, MJ, MW, and DH contributed to data extraction. JK contributed to writing of the manuscript. All authors reviewed the final manuscript.

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Jones, M.D., Wewege, M.A., Hackett, D.A. et al. Sex Differences in Adaptations in Muscle Strength and Size Following Resistance Training in Older Adults: A Systematic Review and Meta-analysis. Sports Med 51, 503–517 (2021). https://doi.org/10.1007/s40279-020-01388-4

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