Pilot study to identify the modification of performance in sarcopenic nursing home patients after introduction of protein and D vitamin supplementation

Milko Zanini1, Annamaria Bagnasco1, Gianluca Catania1, Giuseppe Aleo1, Stefania Ripamonti2, Davide Gonella1, Michela Barisone1, Nicoletta Dasso1 & Loredana Sasso1
1Department of Health Sciences Univeristy of Genova, Italy, 2Private Outpatient Nutritional Service, Brugherio, MB, Italy Journal of Cachexia, Sarcopenia and Muscle 2017; 8: 999–1080 DOI: 10.1002/jcsm.12255

Introduction: In the population between 60 and 70 years prevalence, ratio is from 5 to 13% and in more than 80 year old people the prevalence is between 11 and 50% 1.

The European Working Group on Sarcopenia in Older People (EWGSOP) defined a conceptual framework that shows three level of sarcopenia: pre-sarcopenia, sarcopenia and high sarcopenia.

Recent studies indicate that a vitamin D and leucine- enriched whey protein oral nutritional supplement can im- prove in muscle mass, and lower-extremity function among sarcopenic older adults 2.

Aim: To improve the management of sarcopenic patients in the province of Genoa (IT) and to measure the prevalence of sarcopenia in elderly institutionalised in Genoa using the EWGSOP-defined algorithm.

Methods: Transversal, prospective observational study in nursing homes.

Exclusion criteria: active tumoral disease; severe cognitive impairment; condition against bioimdenziometric analysis. Sarcopenia has been evaluated with the definition and EWGSOP-defined algorithm physical performance: gait speed of using the 4-meter walking; hand grip strength test using Dynax digital dynamometer and evaluation of Skeletal Mus- cle Index (SMI) using BIA vector analysis.

Results: In this pilot, we test 17 people from 2 different nurs- ing homes; we found all 17 patient enrolled at high-level sarcopenia. During observation, the patients were supple- mented with Leucine and Vitamin D with by the nursing home physicians. We provide the same test after three months of therapy, and we found a light modification on EWGSOP indicators.

Discussion: The improvement of EWGSOP parameter, even not significant, allow us to be confident in developing the next RCT to assess parameters in a larger sample of patients. References:

  1. Cruz-JentoftAJ,BaeyensJP,BauerJM,BoirieY,CederholmT,LandiF, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M: Sarcopenia: European consensus on def- inition and diagnosis. Age Ageing 2010, 39(April):412–423

  2. Bauer, Jürgen M, Sjors Verlaan, Ivan Bautmans, Kirsten Brandt, Lorenzo M Donini, Marcello Maggio, Marion E T McMurdo, and others. “Effects of a vitamin D and leucine-enriched whey protein nu- tritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial.” J Am Med Dir Assoc 16, no. 9 (2015): doi:https://doi.org/10.1016/j. jamda.2015.05.021