Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial

Nutritional intake as a determinant of high-speed resistance and multicomponent training efficacy on strength in older women at risk of sarcopenia. A randomized clinical trial

BACKGROUND AND AIM

Despite advances in research on training and nutritional supplementation, it is largely unknown how micronutrient intake modulates the response to training in older adults. This study investigates the relationship between nutrient intake and response to training in older women at risk of sarcopenia.

METHODS

A randomized clinical trial with two parallel groups (high-speed resistance training (H-RT) and multicomponent training (MT)) was conducted over a 32-week intervention involving 80 older women at risk of sarcopenia (mean age: 77.36 ± 6.71 years). A food frequency questionnaire was administered to assess whether nutrient intake influenced strength outcomes measured by the Five Times Sit-to-Stand Test (5STS) and other functional variables.

RESULTS

Significant improvements in the five times sit to stand test (5STS) were observed in both groups post-intervention (p < 0.001), with no significant differences between them (p = 0.127), suggesting comparable effectiveness. In both groups, lower levels of vitamin B12 (H-RT: rp = -0.52; MT: rp = -0.50) and vitamin D (H-RT: rp = -0.55; MT: rp = -0.69) were associated with worse 5STS performance. Additionally, in the H-RT group, lower levels of vitamin E (rp = -0.36), magnesium (rp = -0.48), iron (rp = -0.43), and potassium (rp = -0.47) were also correlated with poorer performance.

CONCLUSIONS

The results indicate that improvements in strength are related to micronutrient sufficiency rather than macronutrient sufficiency. Deficiencies in vitamin D and B12 negatively impacted muscle strength gains in both H-RT and MT, while vitamin E, potassium, magnesium, and iron influenced H-RT outcomes. The lesser effect of micronutrient deficiencies on MT suggests it may be more suitable for individuals with mild deficiencies, as it requires fewer specific nutrients for muscle strength.

REGISTRATION

The study is registered at ClinicalTrials.gov under the identifier NCT05870046.

Association between nutrient patterns and odds of depressive symptomatology: a population-based cohort of older adults followed during 15-y

PURPOSE

Nutrition, as a modifiable exposure, seems relevant to prevent depression. Several nutrients have been associated with a lower risk of depression in older adults, but longitudinal studies examining nutrient combinations are lacking. Therefore, we investigated the association between a posteriori nutrient patterns and the odds of depressive symptomatology (DS) in older adults over time.

METHODS

The sample included participants from the French Three-City cohort, a prospective population-based study focusing on adults ≥ 65 years. Nutrient intakes were assessed using a 24-hour recall in 2001 and Principal Component Analysis based on 40 nutrients, was performed to identify nutrient patterns. DS was assessed at each visit (up to eight visits until 2018) and defined by a Center for Epidemiologic Studies-Depression score ≥ 16 and/or antidepressant medication. Random effect logistic regression was performed to examine the association between nutrient patterns and DS over time controlled for potential confounding variables.

RESULTS

The study sample comprised 1,063 individuals (mean age 75.6y +/- 4.8) and 39.3% experienced DS at least once during a median follow-up of 11.5 years. Among 4 identified nutrient patterns, the first pattern characterised by high intake of magnesium, hydroxybenzaldehydes, stilbenes, dihydroflavonols, vitamin B6, lignans, tyrosols, folates, vitamins B3, B5, B1 and proanthocyanidins, was significantly associated with lower odds of DS over time (OR + 1 point = 0.85, 95% CI=[0.75;0.96]).

CONCLUSIONS

In this large sample of older adults, a mixed nutrient pattern was associated with lower odds of DS over time, offering valuable insights into nutrient potential role in mental health among older adults.

Benefits of home-based foot neuromuscular electrical stimulation on self-reported function, leg pain and other leg symptoms among community-dwelling older adults: a sham-controlled randomised clinical trial

INTRODUCTION

Lower leg pain and symptoms, and poor leg circulation are common in older adults. These can significantly affect their function and quality of life. Neuromuscular electrical stimulation (NMES) applied via the feet as 'foot NMES' activates the leg musculovenous pump. This study investigated the effects of foot NMES administered at home using Revitive® among community-dwelling older adults with lower leg pain and/or other lower leg symptoms such as cramps, or sensations of tired, aching, and heavy feeling legs.

METHODS

A randomised placebo-controlled study with three groups (2 NMES, 1 Sham) and three assessments (baseline, week 8, week 12 follow-up) was carried out. Self-reported function using Canadian occupational performance measure (COPM), leg pain, overall leg symptoms score (heaviness, tiredness, aching, or cramps), and ankle blood flow were assessed. Analysis of covariance (ANCOVA) and logistic regression were used to compare the groups. Statistical significance was set at p < 0.05 (two-sided 5%).

RESULTS

Out of 129 participants enrolled, 114 completed the study. The improvement in all outcomes were statistically significant for the NMES interventions compared to Sham at both week 8 (p < 0.01) and week 12 (p < 0.05). The improvement in COPM met the minimal clinically important difference (MCID) for the NMES interventions compared to Sham at both week 8 (p < 0.005) and week 12 (p < 0.05). Improvement in leg pain met MCID at week 8 compared to Sham (p < 0.05). Ankle blood flow increased approximately 3-fold during treatment compared to Sham. Compliance with the interventions was high and no device-related adverse events were reported.

CONCLUSIONS

The home-based foot NMES is safe, and significantly improved self-reported function, leg pain and overall leg symptoms, and increased ankle blood flow compared to a Sham among older adults.

TRIAL REGISTRATION

The trial was prospectively registered in ISRCTN on 17/06/2019 with registration number ISRCTN10576209. It can be accessed at https://www.isrctn.com/ISRCTN10576209 .

How quality of life is measured in studies of nutritional intervention: a systematic review

BACKGROUND

Nutrition care can positively affect multiple aspects of patient's health; outcomes are commonly evaluated on the basis of their impact on a patient's (i) illness-specific conditions and (ii) health-related quality of life (HRQoL). Our systematic review examined how HRQoL was measured in studies of nutritional interventions. To help future researchers select appropriate Quality of Life Questionnaires (QoLQ), we identified commonly-used instruments and their uses across populations in different regions, of different ages, and with different diseases.

METHODS

We searched EMCare, EMBASE, and Medline databases for studies that had HRQoL and nutrition intervention terms in the title, the abstract, or the MeSH term classifications "quality of life" and any of "nutrition therapy", "diet therapy", or "dietary supplements" and identified 1,113 studies for possible inclusion.We then reviewed titles, abstracts, and full texts to identify studies for final inclusion.

RESULTS

Our review of titles, abstracts, and full texts resulted in the inclusion of 116 relevant studies in our final analysis. Our review identified 14 general and 25 disease-specific QoLQ. The most-used general QoLQ were the Short-Form 36-Item Health Survey (SF-36) in 27 studies and EuroQol 5-Dimension, (EQ-5D) in 26 studies. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ), a cancer-specific QoLQ, was the most frequently used disease-specific QoLQ (28 studies). Disease-specific QoLQ were also identified for nutrition-related diseases such as diabetes, obesity, and dysphagia. Sixteen studies used multiple QoLQ, of which eight studies included both general and disease-specific measures of HRQoL. The most studied diseases were cancer (36 studies) and malnutrition (24 studies). There were few studies focused on specific age-group populations, with only 38 studies (33%) focused on adults 65 years and older and only 4 studies focused on pediatric patients. Regional variation in QoLQ use was observed, with EQ-5D used more frequently in Europe and SF-36 more commonly used in North America.

CONCLUSIONS

Use of QoLQ to measure HRQoL is well established in the literature; both general and disease-specific instruments are now available for use. We advise further studies to examine potential benefits of using both general and disease-specific QoLQ to better understand the impact of nutritional interventions on HRQoL.

Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs

BACKGROUND

Resistance training (RT) and nutritional supplementation are recommended for the management of sarcopenia in older adults. However, optimal RT intensity for the treatment of sarcopenia has not been well investigated.

METHODS

This network meta-analysis aims to determine the comparative effectiveness of interventions for sarcopenia, taking RT intensity into consideration. RT intensity was classified into light-to-moderate intensity RT(LMRT), moderate intensity RT(MRT), and moderate-to-vigorous intensity RT(MVRT) based on percentage of one repetition maximum (%1RM) and/or rating of perceived exertion.

RESULTS

A total of 50 RCTs (N = 4,085) were included after screening 3,485 articles. The results confirmed that RT with or without nutrition was positively associated with improved measures of muscle strength and physical performance. Regarding RT intensity, LMRT only demonstrated positive effects on hand grip (aerobic training + LMRT + nutrition: mean difference [MD] = 2.88; 95% credential intervals [CrI] = 0.43,5.32). MRT provided benefits on improvement in the 30-s chair stand test (repetitions) (MRT: MD = 2.98, 95% CrI = 0.35,5.59), timed up and go test (MRT: MD = -1.74, 95% CrI: = -3.34,-0.56), hand grip (MRT: MD = 2.44; 95% CrI = 0.03,5.70), and leg press (MRT: MD = 8.36; 95% CrI = 1.87,13.4). MVRT also improved chair stand test repetitions (MVRT: MD = 5.64, 95% CrI = 0.14,11.4), gait speed (MVRT + nutrition: MD = 0.21, 95% CrI = 0.003,0.48), appendicular skeletal muscle index (MVRT + nutrition: MD = 0.25, 95% CrI = 0.01,0.5), and leg press (MVRT: MD = 14.7, 95% CrI: 5.96,22.4; MVRT + nutrition: MD = 17.8, 95% CrI: 7.55,28.6).

CONCLUSION

MVRT had greater benefits on muscle mass, lower extremity strength, and physical performance compared to MRT. Increasing RT intensity may be recommended for sarcopenic older adults.

Impact of exercise and leucine-enriched protein supplementation on physical function, body composition, and inflammation in pre-frail older adults: a quasi-experimental study

Background

Exercise and a protein-enriched diet are essential for muscle protein synthesis, cellular growth, mitochondrial function, and immune function. The U.S. Food and Nutrition Board's current guideline on recommended dietary allowance for protein in older adults is 0.8 g/kg per day, which may not be sufficient in vulnerable pre-frail older adults.

Aims

This study aimed to evaluate the impact of leucine-enriched protein supplementation with or without exercise over 3 months in pre-frail older adults who consumed ≤1 g/kg/day of protein on improving (i) physical function, (ii) body composition measures, and (iii) inflammatory biomarkers such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α).

Methods

A non-randomized cluster quasi-experimental study guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist of 178 pre-frail older adults [112 control, 44 nutrition (Nu), and 22 in the nutrition with exercise (Nu+Ex) group] comparing the effect of Nu+Ex and Nu on physical function, body composition, and inflammation. At 0, 3, and 6 months, questionnaires on demographics, depression, perceived health, and cognition were administered. Physical function assessment (short physical performance battery [SPPB] test, gait speed, handgrip strength, 5× sit-to-stand [STS]) was conducted, and body composition analysis was performed using a bioelectrical impedance analysis machine. IL-6 and TNF-α were measured at 0 and 3 months.

Results

At 3 months, there were significant improvements in gait speed, 5× STS, SPPB scores, depression, perceived health, fat-free mass, and appendicular skeletal muscle mass indices in the Nu+Ex group. Both Nu+Ex and Nu groups had improvements in body cell mass and reductions in IL-6 and TNF-α. The improvements were not sustained after 6 months.

Conclusion

Our study results need to be validated in future longitudinal randomized studies with a larger sample size focusing on populations at risk.

Influence of Nutrition on Mental Health: Scoping Review

The aim of this article was to carry out a scoping review of existing research on the influence of food on mental health: (1) Background: nutrition, nutrient levels or an adequate body weight seem to influence the mental health status of individuals. The consumption of psychotropic drugs also seems to contribute to overweight; (2) Methods: fifteen previous research articles were used in the review, which were read in their entirety, following PRISMA methodology and using SPIDER and GRADE tools; (3) Results: there is a relationship between diet and mental health status. Low levels of magnesium, together with high levels of calcium, provoke anxious states, and supplementation with Melissa Officinalis attenuates them. Healthy nutritional habits generally reduce depressive symptoms; while vitamin D supplementation improves mental health status; (4) Conclusion: in general, healthy and appropriate nutrition, such as the Mediterranean diet, improves mental health status. Levels of magnesium, vitamin D, and vitamin B6 also seem to have an influence. As limitations of the present review, "food" was considered any form of nutrient administered as an independent variable, and it may include linguistic and publication bias.

No impact of combining multi-ingredient supplementation with exercise on body composition and physical performance, in healthy middle-aged and older adults: A systematic review and meta-analysis

BACKGROUND

Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi-ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults.

MATERIAL AND METHODS

A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (≥45 years old), following resistance- or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model.

RESULTS

Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI -0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI -0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI -0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI -0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI -0.12 to 0.27).

CONCLUSIONS

No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.

Effects of Physical Activity Interventions in the Elderly with Anxiety, Depression, and Low Social Support: A Clinical Multicentre Randomised Trial

The percentage of older people is increasing worldwide. Loneliness and anxious−depressive states are emerging health conditions in this population group, and these conditions give rise to higher morbidity and mortality. Physical activity (PA) and social relationships have been linked to physical and mental health. The objective of this study was to evaluate whether a 4-month programme of moderate PA in a group would improve the emotional state, levels of social support, and quality of life in a sample of individuals >64 years of age. A multicentre randomised clinical trial was designed in primary care. Ninety (90) participants were selected. After the intervention, there were positive differences between the groups, with significant improvements in the intervention group (IG) in depression, anxiety, health status perception, and social support. Walking in a group two days per week for 4 months reduced clinical depression and anxiety by 59% and 45%, respectively. The level of satisfaction was very high, and adherence was high. In conclusion, the moderate group PA programme improved clinical anxiety, depression, social support, and perceptions of health status in the patients studied.

Dietary Supplementations and Depression

Depression is a mood disturbance condition that occurs for more than two weeks in a row, leading to suicide. Due to adverse effects of depression, antidepressants and adjunctive therapies, such as dietary supplementation, are used for treatment. Therefore, this review explored and summarized dietary supplements’ types, dosages, and effectiveness in preventing and treating depression. A literature search of the PubMed database was conducted in August 2021 to identify studies assessing depression, after which scale measurements based on dietary supplements were identified. From the obtained 221 studies, we selected 63 papers. Results showed PUFA (EPA and DHA combination), vitamin D, and probiotics as the most common supplementation used in clinical studies to reduce depressive symptoms. We also observed that although the total daily PUFA dosage that exhibited beneficial effects was in the range of 0.7–2 g EPA and 0.4–0.8 g DHA daily, with an administration period of three weeks to four months, positive vitamin D-based supplementation effects were observed after administering doses of 2000 IU/day or 50,000 IU/week between 8 weeks and 24 months. Alternatively, microbes from the genus Lactobacillus and Bifidobacterium in the probiotic group with a minimum dose of 10⁸ CFU in various dose forms effectively treated depression. Besides, a depression scale was helpful to assess the effect of an intervention on depression. Hence, PUFA, vitamin D, and probiotics were proposed as adjunctive therapies for depression treatment based on the results from this study.

Association between dietary protein intake and changes in health-related quality of life in older adults: findings from the AusDiab 12-year prospective study

Background

Adequate dietary protein intake is recommended for older adults to optimise muscle health and function, and support recovery from illness, however, its effect on health-related quality of life (HRQoL) is unclear. The aim of this study was to examine the association between total protein intake and different sources of dietary protein and HRQoL in Australians aged 60 years and older over a 12-year period.

Methods

This study used data from the Australian Diabetes, Obesity and Lifestyle study (AusDiab), a 12-year population-based prospective study. The sample included 752 (386 females) adults aged 60 years and older. Protein intake was estimated at baseline (1999/2000) from a 74-item Food Frequency Questionnaire, and HRQoL using the 36-item Short-form Health Survey assessed at baseline (1999/2000) and after 12 years (2011/12). The association between protein intake and change in HRQoL was evaluated using multivariate regression analysis adjusted for relevant confounders. The difference in change in HRQoL between participants with total protein intakes of < 1.0 g/kg/day, intakes of between 1.0–1.2 g/kg/day and intakes of > 1.2 g/kg/day were assessed using one-way ANCOVA.

Results

Total protein intake at baseline was not associated with 12-year changes in physical component summary (PCS) or mental component summary (MCS) scores of HRQoL. Higher animal, red meat and processed animal protein intakes were associated with deteriorations in PCS scores after adjusting for relevant confounders (β = − 0.04; 95% CI: − 0.07, −0.01 ; p = 0.009; β = − 0.05; 95% CI: − 0.08, − 0.01; p = 0.018; β = − 0.17; 95% CI: − 0.31, − 0.02; p = 0.027 respectively). Higher red meat protein intake was associated with deteriorations in MCS scores after adjusting for relevant confounders (β = − 0.04; 95% CI: − 0.08, − 0.01; p = 0.011). There was no difference in 12-year changes in PCS or MCS between participants consuming total protein of < 1.0 g/kg/day, 1.0–1.2 g/kg/day and intakes of > 1.2 g/kg/day.

Conclusion

There was no relationship between total dietary protein intake and HRQoL, but higher protein intakes from animal, red meat and processed animal sources were associated with a deterioration in HRQoL scores over 12 years. Due to the number of associations examined and high drop out of older less healthy participants, further research is required to confirm the associations detected in healthy and less healthy participants, with a view to making protein intake recommendations for older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-02894-y.

A Whole-Grain Diet Increases Whole-Body Protein Balance Compared with a Macronutrient-Matched Refined-Grain Diet

BACKGROUND

There are limited data from randomized control trials to support or refute the contention that whole-grains can enhance protein metabolism in humans.

OBJECTIVES

To examine: 1) the clinical effects of a whole-grain diet on whole-body protein turnover; 2) the cellular effects of whole-grains on protein synthesis in skeletal muscle cells; and 3) the population effects of whole-grain intake on age-related muscle loss.

METHODS

Adults with overweight/obesity (n = 14; age = 40 ± 7 y; BMI = 33 ± 5 kg/m2) were recruited into a crossover, randomized controlled trial (NCT01411540) in which isocaloric, macronutrient-matched whole-grain and refined-grain diets were fully provisioned for two 8-wk periods. Diets differed only in the presence of whole-grains (50 g/1000 kcal). Whole-body protein kinetics were assessed at baseline and after each diet in the fasted-state (13C-leucine) and integrated over 24 h (15N-glycine). In vitro studies using C2C12 cells assessed global protein synthesis by surface sensing of translation and anabolic signaling by Western blot. Complementary epidemiological assessments using the NHANES database assessed the effect of whole-grain intake on muscle function assessed by gait speed in older adults (n = 2783).

RESULTS

Integrated 24-h net protein balance was 3-fold higher on a whole-grain diet compared with a refined-grain diet (P = 0.04). A whole-grain wheat extract increased submaximal rates of global protein synthesis (27%, P < 0.05) in vitro. In a large sample of older adults, whole-grain intake was associated with greater muscle function (OR = 0.92; 95% CI: 0.86, 0.98).

CONCLUSIONS

Consuming 50 g/1000 kcal whole-grains per day promotes greater protein turnover and enhances net protein balance in adults. Whole-grains impact skeletal muscle at the cellular level, and are associated with greater muscle function in older adults. Collectively, these data point to a new mechanism whereby whole-grain consumption favorably enhances protein turnover and improves health outcomes.This clinical trial is registered on clinicaltrials.gov (identifier: NCT01411540).

Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study

BACKGROUND & AIMS

Weight loss in older adults enhances physical function, but may lead to sarcopenia and osteoporosis. Whey protein is a low cost rich source of essential amino acids, may improve physical function. We evaluated the feasibility and acceptability of consuming whey protein in the context of a weight-loss intervention in older adults with obesity.

METHODS

A 12-week pilot feasibility, non-randomized weight loss study of 28 older adults was conducted, consisting of individualized, weekly dietitian visits with twice weekly physical therapist-led group strengthening classes. Half consumed whey protein, three times weekly, following exercise. Preliminary efficacy measures of body composition, sit-to-stand, 6-min walk and grip strength and subjective measures of self-reported health and function were also evaluated.

RESULTS

Of the 37 enrolled, 28 completed the study (50 % in the protein group). Attendance rates for protein vs. non-protein groups were 89.9 ± 11.1 % vs. 95.6 ± 3.4 % (p = 0.08). Protein consumption was high in those attending classes (90.3 %) as was compliance at home (82.6 %). Whey was pleasant (67.3 ± 22.1, range 30-100, above average), had little aftertaste, and was neither salty or sticky. All were compliant (0.64 ± 0.84, range 0-5, low = higher compliance). Both groups lost significant weight (protein vs. no protein, -3.45 ± 2.86 vs. -5.79 ± 3.08, p = 0.47); Sit-to-stand, 6-min walk, and gait speed were no different, grip strength was improved in the protein compared to the non-protein group (-2.63 kg vs. 4.29 kg; p < 0.001).

CONCLUSIONS

Our results suggest that whey protein is a low-cost and readily available nutritional supplement that can be integrated into a weight loss intervention.

Health-related quality of life among rural adults with type 2 diabetes mellitus: a cross-sectional study

BACKGROUND

Previous reports about health-related quality of life (HRQoL) of type 2 diabetes mellitus (T2DM) concentrated on general patients rather than patients in rural areas with poor infrastructure and limited resources. Thus, the aims of this study were to evaluate the HRQoL of diabetics in the countryside and explore its influencing factors.

METHODS

A total of 23 053 participants aged from 18 to 79 years were drawn from the Henan Rural Cohort Study for this cross-sectional study. The HRQoL of participants were assessed by utility index and VAS-score of European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Binary logistic regression, generalized linear and tobit regression models were used to estimate the potential influencing factors on HRQoL.

RESULTS

This study (23 053 participants) included 2231 T2DM patients with a crude prevalence of 9.68%. The utility index and VAS-score in health group were 0.96 ± 0.10 and 78.85 ± 14.53, while in T2DM group were 0.93 ± 0.15 and 74.09 ± 16.09, respectively. In total, most diabetics reported problem about pain/discomfort dimension. Being old, poverty, low physical activity, and with comorbidities was negatively related to HRQoL of diabetics, while high educational level was positively related to HRQoL.

CONCLUSION

HRQoL of rural T2DM patients depended on several sociodemographic factors. More attention should be paid to diabetics with poor socioeconomic status in rural areas.

CLINICAL TRIAL REGISTRATION

The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.

The effect of consuming multivitamin/mineral supplements on elderly quality of life: Based on randomized control trial

BACKGROUND

Clinical trials concerning the effect of supplements or multivitamin on improving the quality of life have proven different results. The present study was conducted to examine the effect of multivitamin supplement on quality of life of the elderly.

MATERIALS AND METHODS

Sixty-four old people over 65 years of age in Kermanshah Elderly Care Center participated in this randomized trial. The samples were first selected using the convenience sampling and then were randomly assigned into intervention and control groups. The intervention group received one multivitamin mineral (MVM) supplement capsule every day for 3 months with no intervention for the control group. Standard quality of life questionnaire was used to collect the data. Data were analyzed using the SPSS software version 22.

RESULTS

The mean age of the participants was 70.77 ± 8.29 years. The results of intra-group evaluation of the aspects of quality of life of the elderly show the lack of significant changes in the mean scores of physical health and environmental health of the elderly in the intervention group (P > 0.05) and the significant reduction of these aspects in the control group (P < 0.05) after intervention. The mean score of mental health scores in the intervention group significantly increased (P = 0.01), but there are no significant changes in the control group (P = 0.273). The mean scores of social relationships as well as the overall score of quality of life in the intervention and control groups showed no significant changes (P > 0.05).

CONCLUSION

The present study showed that the consumption of MVM supplements can have a positive effect on increasing the quality of life of the elderly, but it is recommended to be done in the long term along diet. Moreover, considering the fact that no change was observed in the other aspects of the quality of life, attentions should be paid to the environmental and social factors such as social supports and empowerment of the old people in the future studies.

Mental component of health-related quality of life is an independent predictor of incident functional disability among community-dwelling older people: a prospective cohort study

PURPOSE

Previous studies have reported a positive association between poor health-related quality of life (HRQOL) and disability mainly in relation to the physical component of HRQOL. Given the mental component's responsivity to interventions, this study aimed to investigate whether the mental component of HRQOL independently predicted functional disability.

METHODS

We targeted all residents aged ≥ 65 years in one municipality and analyzed 3858 men and 4475 women without disability at baseline (November 2016). HRQOL was measured using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 Health Survey. At 3-year follow-up (October 2019), incident functional disability was measured, defined as a new certification according to the Japanese long-term care insurance system. Multivariable Poisson regression models stratified by gender were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for functional disability.

RESULTS

Among both genders, there was a significant dose-response relationship between better MCS and lower risk of functional disability, independent of potential confounders including the PCS (P for trend = 0.026 in men and 0.003 in women). Compared with the worst MCS group, the CIRs (95% CIs) for functional disability in the second worst, the middle, the second best, and the best MCS quintile groups were 1.09 (0.80-1.48), 0.58 (0.40-0.85), 0.90 (0.59-1.37), and 0.70 (0.48-1.02) for men, and 0.76 (0.58-1.00), 0.62 (0.46-0.84), 0.73 (0.53-0.99), and 0.63 (0.48-0.85) for women, respectively.

CONCLUSION

The MCS is an independent predictor of functional disability among high-functioning older adults. This suggests that strategies focused on mental HRQOL are important for realizing a healthy, long-lived society.

Correlation of sarcopenia and depressive mood in older community dwellers: a cross-sectional observational study in China

OBJECTIVE

Whether sarcopenia is detrimental to depression is still controversial, which may be due to the three components of the sarcopenia. Our objective was to define the correlation between depression and sarcopenia in older Chinese community dwellers.

DESIGN

The study has a cross-sectional design.

SETTING

The study was conducted in Jiangsu, China.

PARTICIPANTS

A total of 101 men and 149 women aged 60 years or older were recruited.

OUTCOME MEASURES

Lean tissue mass was measured by dual-energy X-ray absorptiometry. Muscle strength in the upper and lower limbs was measured by a handheld dynamometer and a chair stand test, respectively. Physical performance was assessed by gait speed and standing balance tests. Depressive mood was assessed using the Geriatric Depression Scale-30 (range 0-30).

RESULTS

Participants in the sarcopenia group had a higher mean depression score than the normal group (p=0.002). Pearson's correlation analysis showed that depression was negatively associated with muscle strength (handgrip strength: R=-0.170, p=0.028 for women, R=-0.196, p=0.048 for men; chair stand test performance: R=0.252, p=0.002 for women, R=0.311, p=0.001 for men) and physical performance (gait speed: R=-0.200, p=0.009, standing balance test performance: R=-0.224, p=0.006, Short Physical Performance Battery (SPPB): R=-0.218, p=0.007 for women; SPPB: R=-0.252, p=0.01 for men). Multiple linear regression models revealed that depressive mood was inversely associated with chair stand test (β=0.325, p<0.001), gait speed (β=-0.009, p=0.041) and standing balance test (β=-0.24, p=0.016) after adjusting for confounding factors, while no significant correlation was observed between depressive mood and muscle mass.

CONCLUSION

The diagnostic components of sarcopenia-strength of the leg muscles (chair stand test) and physical performance (gait speed and standing balance test)-were associated with depressive mood.

Effect of long-term omega-3 supplementation and a lifestyle multidomain intervention on intrinsic capacity among community-dwelling older adults: Secondary analysis of a randomized, placebo-controlled trial (MAPT study)

OBJECTIVES

To investigate the effect of omega-3 (ω-3) polyunsaturated fatty acid supplementation and a multidomain intervention (MI) (physical activity counselling, cognitive training and nutritional advice) among community-dwelling older adults on levels of intrinsic capacity (IC), a construct recently proposed by the World Health Organization.

STUDY DESIGN

Secondary analysis from the factorial-design 3-year Multidomain Alzheimer Preventive Trial (MAPT) with 1445 subjects (64.2 % female, mean age 75.3 years, SD = 4.4) randomized to one group of MI plus ω-3 (800 mg docosahexaenoic acid and 225 mg eicosapentaenoic acid/day); MI plus placebo; ω-3 supplementation alone; or placebo alone. Data collection was held between 2008 and 2014.

MAIN OUTCOME MEASURES

IC domains were examined with the Geriatric Depression Scale (psychological); Short Physical Performance Battery (mobility); Z-score combining four tests (cognitive function); and handgrip strength (vitality). All domains were combined into a composite IC Z-score.

RESULTS

After 3 years, IC Z-score decreased among all groups when time was considered continuous (MI plus ω-3: -0.16, 95 %CI: -0.22 to -0.10; MI alone: -0.13, 95 %CI: -0.19 to -0.07; ω-3 alone: -0.19, 95 %CI: -0.25 to -0.10; placebo: -0.20, 95 %CI: -0.26 to -0.14; all p < 0.0001). There were no significant differences between groups. In a sensitivity analysis with categorical time, significant within-group declines were first identified at 24 months for all groups.

CONCLUSIONS

This trial designed to improve cognitive function was unable to find effects of the intervention on the composite IC Z-score. Further investigations are needed, especially trials providing stronger interventions (such as exercise training and a controlled diet) and also embracing the sensorial domain of IC.

Physical activity, cardiovascular health and mood state in older adults

Many older adults eat poorly balanced diets and are physically inactive, posing a risk to their cardiovascular and mental health. The benefits of healthful living extend beyond cardiovascular health and disease risk reduction such that physical activity has been shown to positively affect mood state. This was a cross-sectional investigation completed at three senior lunch program sites in Charlotte, NC to assess the status and relationship of nutrition, physical activity patterns, and mood state in older adults, prior to the center offering a new nutritional and physical activity intervention. Some significant relationships between cardiovascular indicators and mood were found.

The effect of vitamin D supplement on negative emotions: A systematic review and meta-analysis

BACKGROUND

The several meta-analyses of the effect of vitamin D on depression have produced inconsistent results and studies dealing with anxiety were not incorporated. There has been no comprehensive analysis of how results are affected by the nature of the sample or the dosage and duration of supplementation. The study is aimed to investigate whether vitamin D supplementation reduces negative emotions and to analyze the possible influence of sample and regimen.

METHOD

We conducted a systematic review and meta-analysis of randomized controlled trials comparing the effect of vitamin D and placebo on negative emotion. Databases were searched for relevant articles published before February 2019.

RESULTS

The analysis covered 25 trials with a total of 7,534 participants and revealed an effect of vitamin D on negative emotion (Hedges' g = -0.4990, 95% CI [-0.8453, -0.1528], p = .0047, I²  = 97.7%). Subgroup analysis showed that vitamin D had an effect on patients with major depressive disorder and on subjects with serum 25(OH)D levels ≤50 nmol/L. The pooled data from trials of vitamin D supplementation lasting ≥8 weeks and dosage ≤4,000 IU/day indicated that vitamin D had an effect.

CONCLUSIONS

Our results support the hypothesis that vitamin D supplementation can reduce negative emotions. Patients with major depressive disorder and individuals with vitamin D deficiency are most likely to benefit from supplementation. But to interpret the results with high heterogeneity should still be cautious.

The Impact of New Biomarkers and Drug Targets on Age-Related Disorders

The increase in the human lifespan has not been paralleled by an increase in healthy life. With the increase in the proportion of the aged population, there has been a natural increase in the prevalence of age-related disorders, such as Alzheimer's disease, type 2 diabetes mellitus, frailty, and various other disorders. A continuous rise in these conditions could lead to a widespread medical and social burden. There are now considerable efforts underway to address these deficits in preclinical and clinical studies, which include the use of better study cohorts, longitudinal designs, improved translation of data from preclinical models, multi-omics profiling, identification of new biomarker candidates and refinement of computational tools and databases containing relevant information. Such efforts will support future interdisciplinary studies and help to identify potential new targets that are amenable to therapeutic approaches such as pharmacological interventions to increase the human healthspan in parallel with the lifespan.