Abstract: Objective: To systematically evaluate the effects of exercise combined with nutritional support on the elderly with frailty or pre-frailty. Methods: Randomized controlled trials, which explored the effects of exercise combined nutrition support on the elderly with frailty or pre-frailty, were searched in China journal full-text database (CNKI), wanfang database, VIP database, China biomedical literature database (CBM), The Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL. After screening the literature, extracting the data and evaluating the quality of the literature, Meta-analysis was performed using RevMan 5.3 software. Results: A total of 11 randomized controlled trials involving 853 old people were finally included. According to the Meta-analysis, exercise combined nutrition support could reverse the frailty state [OR=2.46, 95%CI (1.33, 4.55), P=0.004], increase hand grip [MD=2.10, 95%CI (1.53,2.68), P<0.001], increase walking speed [MD=0.07, 95%CI (0.03, 0.12), P=0.003], and increase energy intake [MD=0.40, 95%CI (0.26,0.54), P<0.001]. But there was no obvious advantage in improving the quality of life, leg extension force, balance and lean body weight, and the combined effect was not statistically significant (P>0.05). Conclusion: Exercise combined with nutritional support could reverse the frailty state and improve physical function, but it may not improve nutritional status. Further researches are needed in this area.

Key words: exercise; nutrition; frailty; Meta-analysis