Bauer JM, Verlaan S, Bautmans I, et al.
J Am Med Dir Assoc 2015;16:740-747
Publication date: September 1, 2015
Summary
Preserving physical mobility, function and independent living is of utmost importance for frail older adults. Sarcopenia, the age-related loss of muscle mass, strength and function makes up a large component of physical frailty. It is a strong risk factor for reduced mobility, falls and fractures, and is directly related to rates of hospital and long-term care admissions, increased disability, reduced independence and quality of life. Although exercise is the standard treatment for increasing muscle strength and improving physical performance among adults with sarcopenia, it may be difficult to implement in the presence of mobility limitations.
In this multicenter, randomized, controlled, double-blind trial (the PROVIDE study), the authors tested the hypothesis that a specific oral nutritional supplement can result in improvements in measures of sarcopenia. A total of 380 sarcopenic, primarily independent-living older adults with Short Physical Performance Battery (SPPB; 0–12) scores between 4 and 9 and a low skeletal muscle mass index were enrolled in the study.
The active group (n = 184) received a vitamin D and leucine-enriched whey protein nutritional supplement to consume twice daily for 13 weeks. The control group (n = 196) received an iso-caloric control product to consume twice daily for 13 weeks. Primary outcomes of handgrip strength and SPPB score, and secondary outcomes of chair-stand test, gait speed, balance score, and appendicular muscle mass (by DXA) were measured at baseline, week 7, and week 13 of the intervention.
Handgrip strength and SPPB improved in both groups without significant between-group differences. The active group improved more in the chair-stand test compared with the control group; the between-group effect (95% confidence interval) was −1.01 seconds (−1.77 to −0.19; P = 0.018). The active group gained more appendicular muscle mass than the control group; tbetween-group effect was 0.17 kg (0.004–0.338; P = 0.045).
This 13-week specific nutrition intervention among sarcopenic older adults with mobility limitations did not lead to significant differences in SPPB or handgrip strength. There were, however, significant gains in muscle mass and improvements in chair stand ability in the active group versus control. This study provides proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients, which is especially relevant for those who are unable to exercise. These results warrant further investigations into the role of a specific nutritional supplement as part of a multimodal approach to prevent adverse outcomes among older adults at risk for disability.