SHAPE study: Nutritional needs and physical function in community dwelling geriatric outpatients to counteract sarcopenia and ultimately preserve daily function (WC2014-081)

Background

Starting date: 01/07/2015

Sarcopenia, low muscle mass, is one of the undesirable factors leading to physical disability, poor quality of life, loss of independence, and death in older persons (1, 2).The absence of physical activity diminishes muscle health(3-5) and a sufficient intake of nutrients, especially protein, has been shown to increase protein synthesis, necessary to regain muscle health (6, 7).

Very limited data exist in the vulnerable group of elderly referred to geriatric outpatient clinics regarding their muscle related parameters (muscle mass, muscle strength, physical performance). However, data is lacking on physical activity and nutritional status in geriatric outpatients. In geriatric outpatients, the prevalence of malnutrition as defined by the Mini Nutritional Assessment (MNA) is 17%, while 58% are at risk for malnutrition (8). Nutritional requirements of the geriatric outpatient population are largely unknown, and therefore nutritional deficiencies are also poorly understood (9). 

In clinical practice, optimization of physical and nutritional intervention (“tailored therapy”) to overcome sarcopenia is prevented by lack of knowledge on estimated needs of patients and the interrelation of physical activity and nutritional status. The present study aims to define clusters of patients based on muscle related parameters (muscle mass, muscle strength, physical performance), energy expenditure (actual physical activity and basal metabolic rate) and nutritional status (energy and protein intake vs. needs) in an inception cohort of patients referred to the geriatric outpatient clinic of the Center of Geriatric Medicine Amsterdam (COGA), VU medical center in Amsterdam.

 

References

1.         Landi F, Liperoti R, Fusco D, et al. Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc. 2012;13(2):121-6.

2.         Bijlsma AY, Pasma JH, Lambers D, et al. Muscle Strength Rather Than Muscle Mass Is Associated With Standing Balance in Elderly Outpatients. J Am Med Dir Assoc. 2013;14(7):493-8.

3.         Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147(8):755-63.

4.         Newman AB, Kupelian V, Visser M, et al. Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc. 2003;51(11):1602-9.

5.         Zoico E, Di Francesco V, Guralnik J, et al. Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes. 2004;28(2):234-41.

6.         Boirie Y, Morio B, Caumon E, et al. Nutrition and protein energy homeostasis in elderly. Mech Ageing Dev. 2014;136:76-84.

7.         Welch AA. Nutritional influences on age-related skeletal muscle loss. Proc Nutr Soc. 2013:1-18.

8.         van Bokhorst-de van der Schueren MA, Lonterman-Monasch S, de Vries OJ, et al. Prevalence and determinants for malnutrition in geriatric outpatients. Clin Nutr. 2013;32(6):1007-11.

9.         Ocke MC, Buurma-Rethans E, De Boer E, et al. Diet of community-dwelling older adults: Dutch National Food Consumption Survey Older adults 2010-2012. RIVM rapport 050413001. 2013.