Abstract

Pre-sarcopenia, characterized by low muscle mass but largely preserved physical function, is a critical period for intervention. Seventy-seven older adults were assigned to 12-month resistance training (n = 40) or control (n = 37).  Lean mass, fatmass, handgrip strength, and gait velocitywere measured at baseline, 3, 6, and 12 months. By 12 months, the training group gained 1.2 kg total lean mass (95% CI: 0.8–1.6) with an 8.4% arm lean mass increase. Handgrip strength rose 2.1 kg (95% CI: 1.3–2.9) and correlated with arm lean mass (r = 0.68). Clinically meaningful gains (≥ 2.0 kg grip or ≥ 1.0 kg lean mass) occurred in 65% of trainees versus 22% of controls (p < 0.001). Gait velocity improved more in the training group (0.17 vs. -0.08 m/s). These findings highlight resistance training's role in  preventing muscle decline and highlight handgrip strength as an accessible marker of improvement.