BACKGROUND: Previous evidence showed that cellular aging is a multifactorial process that is associated with decline in mitochondrial function. Physical exercise has been proposed as an effective and safe therapeutical intervention to improve the mitochondria network in the adult myocytes. AIMS: The aim of this systematic review of randomized controlled trials (RCTs) was to assess the exercise-induced muscle mitochondria modifications in older adults, underlining the differences related to different exercise modalities. METHODS: On November 28th, 2021, five databases (PubMed, Scopus, Web of Science, Cochrane, and PEDro) were systematically searched for RCTs to include articles with: healthy older people as participants; physical exercise (endurance training (ET), resistance training (RT), and combined training (CT)) as intervention; other different exercise modalities or physical inactivity as comparator; mitochondrial modifications (quality, density and dynamics, oxidative, and antioxidant capacity) as outcomes. The quality assessment was performed according to the PEDro scale; the bias risk was evaluated by Cochrane risk-of-bias assessment tool. RESULTS: Out of 2940 records, 6 studies were included (2 assessing ET, 2 RT, 1 CT, and 1 both ET and RT). Taken together, 164 elderly subjects were included in the present systematic review. Significant positive effects were reported in terms of mitochondrial quality, density, dynamics, oxidative and antioxidant capacity, even though with different degrees according to the exercise type. The quality assessment reported one good-quality study, whereas the other five studies had a fair quality. DISCUSSION: The overall low quality of the studies on this topic indicate that further research is needed. CONCLUSION: RT seems to be the most studied physical exercise modality improving mitochondrial density and dynamics, while ET have been related to mitochondrial antioxidant capacity improvements. However, these exercise-induced specific effects should be better explored in older people.

Department of Health Sciences University of Eastern Piedmont A Avogadro Novara Italy

Department of Medical and Surgical Sciences University of Catanzaro Magna Graecia Catanzaro Italy

Department of Oncology and Hemato Oncology University of Milan Milan Italy

Department of Rehabilitation Medicine 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Dipartimento Attività Integrate Ricerca e Innovazione Translational Medicine Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy

Division of Pathology IEO European Institute of Oncology IRCCS Milan Italy

Medical and Pharmaceutical Biotechnologies University of Pavia Pavia Italy

Physical and Rehabilitative Medicine Department of Medical and Surgical Sciences University of Catanzaro Magna Graecia Viale Europa 88100 Catanzaro Italy

Physical Medicine and Rehabilitation Unit Department of Neurosciences ASST Carlo Poma Mantova Italy

Rehabilitation Unit Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy

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