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Published online by Cambridge University Press: 16 December 2024
The POWER study (NCT05688956) is a 12-week randomised controlled trial (ongoing) investigating the effectiveness of a novel protein-based oral nutritional supplement combined with an online resistance training programme for community-dwelling adults aged 70+ who require home care and are at risk of sarcopenia. Older adults reliant on home care are an understudied cohort acknowledged as vulnerable to sarcopenia(1) and malnutrition(2). This study aims to report the preintervention (baseline) functional status and dietary intake of older adults recruited to the POWER study.
Community-dwelling adults (≥70 y) living in Ireland receiving supportive home care and at risk of sarcopenia. Sarcopenia was screened for using the Strength, Assistance walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire with a cut-off score of ≥1(3) (out of 10). Participants were recruited into the POWER study between July 2023 and January 2024. Data on participant demographic, nutritional status (anthropometric measures and 24-hour multiple-pass dietary recall) and muscle strength (handgrip strength (Jamar® dynamometer) and five times sit-tostand) were obtained during pre-intervention home visits. Dietary intake was analysed using NutriticsTM software (version 5.96). Intakes of protein and kilocalories were calculated as grams per kilogram body weight (g/kgBW) and as kilocalorie per kilogram body weight (kcal/kgBW) respectively. Statistical analysis was performed using RStudio (2023.06.2).
Seventeen adults aged 70+ were recruited over a 7-month period (12F, 5M; age range 71-87 years). Ten participants were receiving informal home care (i.e., from a relative) with seven receiving professional home care. All participants had a SARC-F score over 4, with a mean score of 5±1.3. Median BMI was 28.7 (range 17.1-36.2) kg/m2. One participant was underweight (BMI 17.1 kg/m2), five were overweight (BMI ≥24.9 kg/m2) and six were living with obesity (BMI ≥30 kg/m2). Using the Mini-Nutritional Assessment-Full Form (MNA-FF), nine participants were at risk of malnutrition (MNA-FF 17–23.5), and one was malnourished (MNA-FF =16.5). Mean intake of protein was 0.84±0.23 g/kgBW/day, with only two participants consuming ≥1.0 g/kgBW/day. Mean daily energy intake was 1,488 kcal or 17.0 kcal/kgBW. Time taken for five times sit-to-stand was 21±8 seconds (>15 seconds for five rises(4)) and handgrip strength was 15±6 kg (<16 kg for females(4)) and 21±12 kg (<27 for males(4)) for females and males, respectively.
Analysis of the pre-intervention data from the POWER study indicates that older adults at risk of sarcopenia are not meeting recommended daily protein intakes of 1-1.2 g/kgBW(5). Participants also demonstrated poor muscle strength. This highlights the need for a multi-component approach to support dietary intake and muscle strength in older adults reliant on home care.
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