Unveiling the potential of a whey protein- and leucine-enriched multi-nutrient formula high in vitamin D3: A scoping review on its role in enhancing body composition, strength, and physical function in sarcopenia

A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial

The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.

Alpha-actinin-3 (ACTN-3), a structural protein in type II skeletal muscle fibers, is important for maintaining structure of the myofibrillar array. Although not all studies agree, recent data suggest that the R577X variant in the ACTN3 gene explains some of the inter-individual variability in muscle functioning in older adults. PURPOSE: To examine the association of the ACTN3R577X polymorphism with muscle function and physical performance in older adults. METHODS: To determine the association of the R577X polymorphism (RR, RX, & XX groups) with muscle function and physical performance, we measured knee extensor torque, mid-thigh muscle cross-sectional area, muscle quality, short physical performance battery score, and 400-meter walk time at baseline and after five-years of age in white older adults between the ages of 70-79 yr in the Health, Aging and Body Composition (Health ABC) Study cohort (n = 1,367). Incident persistent lower extremity limitation (PLL) over five-years was also assessed. The X-homozygote frequency in the black sub-group was too low to include in the analysis. RESULTS: There were no significant differences between R577X genotype groups in men or women for baseline muscle function or for performance phenotypes, when these data were adjusted for potential confounders. Men who were X-homozygotes had a significantly greater adjusted five-year increase in their 400-meter walk time compared to R-homozygotes (p= 0.008) and heterozygotes (p= 0.075). In women, R-homozygotes had an ∼ 35% lower risk of incident PLL compared to X-homozygotes (HR = 0.65, 95% CI = 0.44 - 0.94), but this association was not observed in men. CONCLUSIONS: The present results indicate the ACTN3R577X polymorphism may influence declines in physical performance with age in older white adults. However, the influence of the ACTN3R577X polymorphism should be interpreted with caution based on the strength of these associations and lack of a replication sample. This research was supported in part by the Intramural Research Program of the NIH, National Institute on Aging. NIA contract #s: N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106.

Periodized and non-periodized resistance training programs on body composition and physical function of older women.

Deteriorating sleep quality and physical or mental fatigue in older adults leads to decreased quality of life and increased mortality rates. This study investigated the effects of the time-dependent intake of nicotinamide mononucleotide (NMN) on sleep quality, fatigue, and physical performance in older adults. This randomized, double-blind placebo-controlled study evaluated 108 participants divided into four groups (NMN_AM; antemeridian, NMN_PM; post meridian, Placebo_AM, Placebo_PM). NMN (250 mg) or placebo was administered once a day for 12 weeks. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Fatigue was evaluated using the “Jikaku-sho shirabe” questionnaire. Grip strength, 5-times sit-to-stand (5-STS), timed up and go, and 5-m habitual walk were evaluated to assess the physical performance. Significant interactions were observed between 5-STS and drowsiness. 5-STS of all groups on post-intervention and drowsiness of the NMN_PM and Placebo_PM groups on mid- and post-intervention showed significant improvement compared with those in pre-intervention. The NMN_PM group demonstrated the largest effect size for 5-STS (d = 0.72) and drowsiness (d = 0.64). Overall, NMN intake in the afternoon effectively improved lower limb function and reduced drowsiness in older adults. These findings suggest the potential of NMN in preventing loss of physical performance and improving fatigue in older adults.

Exploring the association between handgrip, lower limb muscle strength, and physical function in older adults: A narrative review.

Effects of Resistance Exercise Training on Cognitive Function and Physical Performance in Cognitive Frailty: A Randomized Controlled Trial.

BackgroundIncreased physical activity and dietary protein intake are promising interventions to prevent or treat the age-related decline in physical performance in older adults. There are well-controlled exercise as well as dietary intervention studies that show beneficial effects on physical performance in older adults. In practice, however, weekly group based exercise or nutritional programs may not be as effective. To optimise these exercise programs for community dwelling older adults, a digitally supported and personalised home-based exercise training program has been designed aiming to improve physical performance in older adults. In addition, a protein intervention in combination with the training program may further improve physical performance in older adults.MethodsThe VITAMIN study will be a cluster randomised controlled trial with three parallel arms. In total, 240 community dwelling older adults (≥ 55 years) participating in weekly group exercise are randomly allocated into: 1) regular weekly exercise program (Control group, n = 80), 2) digitally supported personalised home-based exercise training program group (VITA group, n = 80) and 3) digitally supported personalised home-based exercise training program group plus dietary protein counselling (VITA-Pro group, n = 80). The VITAMIN study aims to evaluate effectiveness of the digitally supported personalised home-based exercise training program as well as the additional value of dietary protein on physical performance after 6 months. In addition, a 12 month follow-up measurement will assess the retaining effect of the interventions. Primary outcome is physical performance measured by the Modified Physical Performance Test (M-PPT) and relevant secondary and observational outcomes include habitual physical activity and dietary intake, body composition, cognitive performance, quality of life, compliance and tablet usage. Data will be analysed by Linear Mixed Models.DiscussionTo our knowledge, the VITAMIN study is the first study that investigates the impact of home-based exercise, protein intake as well as use of persuasive technology in the population of community dwelling older adults.Trial registrationNL56094.029.16 / NTR (TC = 5888; registered 03–06-2016).

BackgroundSensory and cognitive function can impact physical performance, but the relationship of multiple sensory impairments (SIs) with mobility in older adults is not well understood. We hypothesized that severity and number of SIs would be associated with worse timed physical mobility performance, and that cognitive processing speed would mediate the association.MethodsParticipants (N = 832) were older adults (mean age 76.3 ± 5.0 years; 59.4% women; 84.2% non-Hispanic White) who completed tests of physical performance, cognitive function, and multiple sensory domains. Separate linear regression models examined the association of SI with 400-m walk, expanded Short Physical Performance Battery (eSPPB), 4-square step test (FSST), and stair climb test. Cognitive measures of executive function/processing speed (Digit Symbol Coding [DSC] and Trail Making Test [Trails] B) were tested as potential mediators of the relationship between SI and physical performance.ResultsEach 1-point decrement in SI scale was associated with slower 400-m walking speed (β = −0.01 m/s, p = .03), lower eSPPB score (β = −0.05 points, p < .001), and longer FSST time (β = 0.20 seconds, p = .01), but there was no association with stair climb time. Using a causal mediation approach with DSC and Trails B as potential mediators, 47.9% of the association of SI with 400-m walk, 43.8% of the association of SI with eSPPB, and 56.7% of the association of multiple SI with FSST were mediated.ConclusionsGreater SIs were associated with worse physical performance in older adults, and the association was partially mediated by measures of cognitive processing speed and executive function. Future studies should investigate the temporal relationship between SIs, cognitive function, and physical function.

The Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2): Design and methods

This systematic review reports the most recent literature regarding the effects of physical exercise on muscle strength, body composition, physical functioning and inflammation in older adults. All articles were assessed for methodological quality and where possible effect size was calculated. Thirty-four articles were included - four involving frail, 24 healthy and five older adults with a specific disease. One reported on both frail and nonfrail patients. Several types of exercise were used: resistance training, aerobic training, combined resistance training and aerobic training and others. In frail older persons, moderate-to-large beneficial exercise effects were noted on inflammation, muscle strength and physical functioning. In healthy older persons, effects of resistance training (most frequently investigated) on inflammation or muscle strength can be influenced by the exercise modalities (intensity and rest interval between sets). Muscle strength seemed the most frequently used outcome measure, with moderate-to-large effects obtained regardless the exercise intervention studied. Similar effects were found in patients with specific diseases. Exercise has moderate-to-large effects on muscle strength, body composition, physical functioning and inflammation in older adults. Future studies should focus on the influence of specific exercise modalities and target the frail population more.

Effect of multicomponent intervention on malnutrition in older adults: A multicenter randomized clinical trial

Slimming down in old age

The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.

This study investigated the relationship between subjective grip strength and physical function in community-dwelling older women. Subjective grip strength was assessed using a questionnaire, and physical function and body composition were compared between groups with strong and weak subjective grip strength. Additionally, the two groups were compared in those with mild cognitive impairment (MCI) and those with normal cognitive function, respectively. The results showed significant differences in grip strength (p < 0.001), 30 s chair-stand (CS-30) test (p = 0.039), timed up-and-go (TUG) test (p = 0.027), maximal gait speed (p = 0.029), and skeletal muscle mass (p < 0.001). Older adults with normal cognitive function showed significant differences in grip strength (p < 0.001), quadriceps muscle strength (p < 0.009), one-leg standing time (p = 0.041), CS-30 (p = 0.002), TUG (p = 0.014), gait speed (p = 0.006), and skeletal muscle mass (p = 0.003). Older adults with low subjective grip strength had lower physical function and skeletal muscle mass. However, no items showed significant differences between groups among older adults with MCI. Thus, subjective grip strength is an indicator of an overall decline in physical function and a reduction in skeletal muscle mass in older adults, and cognitive function should be considered when assessing subjective grip strength in older adults.