EFFECTS OF GLP-1 RECEPTOR AGONISTS ON MUSCULOSKELETAL AND FUNCTIONAL OUTCOMES IN OLDER ADULTS: AN INTEGRATIVE LITERATURE REVIEW

Abstract

Objective: To analyse the effects of glucagon-like peptide-1 receptor agonists (GLP-1 RA) on musculoskeletal and functional outcomes in older adults. Methods: integrative review comparing older adults who did and did not use these drugs, with searches in PubMed/MEDLINE, Embase, the Cochrane Library and LILACS covering studies in humans with older populations published between 2021 and 2026, following the PRISMA 2020 flow. Results: of 442 records identified, 15 made up the sample. Studies using direct measures documented reductions in the appendicular skeletal muscle mass index, handgrip strength and gait speed among those exposed to semaglutide, although part of the lean mass loss measured by bioimpedance corresponded to body water. Bone loss tracked weight reduction: no effect on a formation marker, but a rise in a resorption marker and lower bone mineral density. For fracture risk, the largest cohort (133,606 adults) retained a protective effect beyond age 75, yet the effect reversed among participants without diabetes; in that group risk rose with age, reaching an odds ratio of 4.99 (95% CI 2.68–9.26) at 78 to 88 years. Conclusion: prescribing to older adults requires assessment of body composition and physical performance, with particular attention to those without diabetes.