Jones · Sports medicine (Auckland, N.Z.) 2021 · systematic review and meta-analysis · n=30 studies (1410 participants)

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

Cited 95 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of comparative intervention studies

PubMed 33332016 · doi:10.1007/s40279-020-01388-4 · record verified 2026-08-29

What was done

A systematic review and meta-analysis searching five databases (Web of Science, Science Direct, SPORTDiscus, CINAHL, MEDLINE) from inception to June 2020. Included studies evaluated males and females over 50 years old performing identical resistance training protocols with muscle strength or size outcomes. Study quality was appraised using a modified Downs and Black checklist.

What was found

Thirty studies (41 comparison groups, 1410 participants: 651 males, 759 females; mean quality score 14.7/29) were analyzed. Relative gains: Females gained significantly more relative lower-body strength than males (g = -0.21 [95% CI -0.33, -0.10], p = 0.0003), while relative upper-body strength (g = -0.29 [95% CI -0.62, 0.04], p = 0.08) and relative muscle size (g = 0.10 [95% CI -0.04, 0.23], p = 0.16) showed no significant sex differences. Absolute gains: Males gained significantly 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).

Why it matters

It demonstrates that whether sex differences appear to exist in older adults' resistance training adaptations depends almost entirely on whether outcomes are measured in absolute or relative terms.

Limits

The average methodological quality of included studies was only moderate (14.7/29). The abstract does not detail training duration, intensity, specific measurement modalities for muscle size, or dietary controls across the included trials.

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