A systematic review and meta-analysis of the effects of older age on skeletal muscle mitochondrial function, as measured by 31P magnetic resonance

Cameron, Donnie ORCID: https://orcid.org/0000-0001-9841-6909, Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Vermeulen, Laura J., Malekzadeh, Arjan, Vassiliou, Vassilios S. ORCID: https://orcid.org/0000-0002-4005-7752 and Hooijmans, Melissa T. (2026) A systematic review and meta-analysis of the effects of older age on skeletal muscle mitochondrial function, as measured by 31P magnetic resonance. UNSPECIFIED.

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Abstract

Objective: Loss of skeletal muscle mass and performance is a hallmark of ageing. Mitochondrial function has been suggested as a critical determinant of skeletal muscle performance. However, mixed results have been reported regarding mitochondrial function in older individuals. Therefore, the primary objective of this systematic review is to determine whether 31P-MRS-derived τPCr, reflecting mitochondrial oxidative capacity, is reduced in ageing skeletal muscle. Methods: A preregistered systematic literature review was performed using the databases MEDLINE, EMBASE, SPORTDiscus, and Cochrane Central Register of Controlled Trials (CENTRAL). Papers were included if they reported τPCr as measured by 31P-MRS; and studied individuals over 65 years of age in combination with a younger control group. Differences between young and older groups were assessed using random effects meta-analysis. Results: We included 20 papers in total, of which 2 measured 2 muscles, 5 focused on the tibialis anterior (TA) muscle, 11 on the calf muscles, 5 on the quadriceps, and 1 on the flexor digitorum longus. No statistically-significant differences were found in τPCr between older and younger adults for all muscles combined (Hedges’ g=0.11 (p=0.487). Inter-study heterogeneity was high (τ2=0.36, I2=72.49%, H2=3.64). Sub-analyses for the individual muscles showed longer τPCr in the quadriceps (g=0.65, p<0.001) in older adults, but shorter τPCr in the TA muscle (g=−0.64, p<0.001). For the calf muscles, no differences were detected between older and young individuals (g=0.20, p=0.377). Conclusion: No uniform age-related decline was found for τPCr when comparing all studies together. Substantial heterogeneity was observed between the individual muscles, with τPCr being prolonged in the upper leg muscles in older adults, but shortened in the tibialis anterior. This suggests more work using standardised settings and well-defined cohorts is needed.

Item Type: Other
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Medicine and Health Sciences > Research Centres > Public Health
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Science > Research Groups > Statistics
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
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Depositing User: LivePure Connector
Date Deposited: 02 Jul 2026 08:37
Last Modified: 02 Jul 2026 08:37
URI: https://ueaeprints.uea.ac.uk/id/eprint/103594
DOI: 10.64898/2026.05.02.722217

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