Effect of different nutrient interventions on physical function of elderly with frailty: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Anshi ¹ , WAN Jingjing ² , ZHU Lijun ¹ , WEN Liying ¹ , CHANG Weiwei ¹ ,  JIN Yuelong ¹

1. School of Public Health, Wannan Medical College, Wuhu 241000, P. R. China;
2. Anhui College of Traditional Chinese Medicine, Wuhu 241000, P. R. China;

Corresponding author：

JIN Yuelong, Email: jiny10803@wnmc.edu.cn

Keywords：

Frailty; Elderly; Physical function; Network meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202207155

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effect of different nutrient interventions on the physical function of elderly people with frailty through network meta-analysis. Methods The PubMed, Cochrane Library, EMbase and Web of Science were electronically searched to collect randomized controlled trials of different nutrient interventions on physical function of the elderly with frailty, from database inception to June 30, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using ADDIS 1.16.8, GeMTC 14.3, and Stata 15.0 software. Results A total of 13 studies involving 1 144 patients were included. There was no statistically significant difference in handgrip strength, time up to go test, gait speed, and short physical performance battery (SPPB) among different nutrient interventions. Significant differences were not found in vitamin D+ whey protein (VDWP) vs. placebo and Leu vs. placebo in handgrip strength, or VDWP vs. placebo in SPPB. The probability ranking diagram showed that the most effective of handgrip strength, time up to go test, gait speed, and SPPB were milk protein concentrate (MPC80), L-carnitime (L-Car), leucine (Leu), and MPC80, respectively. Conclusion The current evidence suggests that nutritional intervention did not significantly improve physical function in the frail elderly. MPC80, Leu, L-Car, and VDVEWP may play a role in improving the physical function of frail elderly people. Nutritional support programs that increase the above nutrients, combined with exercise training may become a better way to improve the physical function of frail elderly.

Citation： WANG Anshi, WAN Jingjing, ZHU Lijun, WEN Liying, CHANG Weiwei, JIN Yuelong. Effect of different nutrient interventions on physical function of elderly with frailty: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(3): 303-310. doi: 10.7507/1672-2531.202207155 Copy

1.	龚锋, 邓龙真. 人口老龄化、跨区人口流动与县域经济增长. 中南财经政法大学学报, 2022, (1): 147-160.
2.	谢攀攀. 中国人口老龄化新特点与地区老龄化差异—基于全国人口普查数据的实证分析. 黑龙江人力资源和社会保障, 2022, (13): 27-29.
3.	Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
4.	Lee H, Lee E, Jang IY. Frailty and comprehensive geriatric assessment. J Korean Med Sci, 2020, 35(3): e16.
5.	肖丽萍, 楚伟英, 张志宏, 等. 养老机构老年人营养风险与衰弱状况分析. 中国卫生标准管理, 2020, 11(11): 11-15.
6.	毛国菊. 住院老年人整体衰弱与社会衰弱现状及相关性研究. 沈阳: 中国医科大学, 2021.
7.	Daniels R, van Rossum E, de Witte L, et al. Interventions to prevent disability in frail community-dwelling elderly: a systematic review. BMC Health Serv Res, 2008, 8: 278.
8.	Shim S, Yoon BH, Shin IS, et al. Network meta-analysis: application and practice using Stata. Epidemiol Health, 2017, 39: e2017047.
9.	Vaes AMM, Tieland M, Toussaint N, et al. Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. J Nutr, 2018, 148(5): 712-720.
10.	Bauer JM, Verlaan S, Bautmans I, et al. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2015, 16(9): 740-747.
11.	Abe S, Ezaki O, Suzuki M. Medium-chain triglycerides in combination with leucine and vitamin D increase muscle strength and function in frail elderly adults in a randomized controlled trial. J Nutr, 2016, 146(5): 1017-1026.
12.	Bo Y, Liu C, Ji Z, et al. 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. Clin Nutr, 2019, 38(1): 159-164.
13.	Björkman MP, Suominen MH, Kautiainen H, et al. Effect of protein supplementation on physical performance in older people with sarcopenia-a randomized controlled trial. J Am Med Dir Assoc, 2020, 21(2): 226-232.
14.	Martínez-Arnau FM, Fonfría-Vivas R, Buigues C, et al. Effects of leucine administration in sarcopenia: a randomized and placebo-controlled clinical trial. Nutrients, 2020, 12(4): 932.
15.	Munguia L, Rubio-Gayosso I, Ramirez-Sanchez I, et al. High flavonoid cocoa supplement ameliorates plasma oxidative stress and inflammation levels while improving mobility and quality of life in older subjects: a double-blind randomized clinical trial. J Gerontol A Biol Sci Med Sci, 2019, 74(10): 1620-1627.
16.	Kim H, Suzuki T, Kim M, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS One, 2015, 10(2): e0116256.
17.	Badrasawi M, Shahar S, Zahara AM, et al. Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial. Clin Interv Aging, 2016, 11: 1675-1686.
18.	Tieland M, Dirks ML, van der Zwaluw N, et al. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2012, 13(8): 713-719.
19.	Roschel H, Hayashi AP, Fernandes AL, et al. Supplement-based nutritional strategies to tackle frailty: a multifactorial, double-blind, randomized placebo-controlled trial. Clin Nutr, 2021, 40(8): 4849-4858.
20.	Kang L, Gao Y, Liu X, et al. Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: a multicenter study in China. Arch Gerontol Geriatr, 2019, 83: 7-12.
21.	Peng LN, Cheng YC, Yu PC, et al. Oral nutritional supplement with β-hydroxy-β-methylbutyrate (HMB) improves nutrition, physical performance and ameliorates intramuscular adiposity in pre-frail older adults: a randomized controlled trial. J Nutr Health Aging, 2021, 25(6): 767-773.
22.	Walston J, Buta B, Xue QL. Frailty screening and interventions: considerations for clinical practice. Clin Geriatr Med, 2018, 34(1): 25-38.
23.	Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing, 2018, 47(2): 193-200.
24.	Cesari M, Calvani R, Marzetti E. Frailty in older persons. Clin Geriatr Med, 2017, 33(3): 293-303.
25.	Bonnefoy M, Berrut G, Lesourd B, et al. Frailty and nutrition: searching for evidence. J Nutr Health Aging, 2015, 19(3): 250-257.
26.	Howard C, Ferrucci L, Sun K, et al. Oxidative protein damage is associated with poor grip strength among older women living in the community. J Appl Physiol (1985), 2007, 103(1): 17-20.
27.	Moraes MB, Avgerinou C, Fukushima FB, et al. Nutritional interventions for the management of frailty in older adults: systematic review and meta-analysis of randomized clinical trials. Nutr Rev, 2021, 79(8): 889-913.
28.	Yoshimura Y, Wakabayashi H, Yamada M, et al. Interventions for treating sarcopenia: a systematic review and meta-analysis of randomized controlled studies. J Am Med Dir Assoc, 2017, 18(6): 553.e1-553.e16.
29.	Dedeyne L, Deschodt M, Verschueren S, et al. Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv Aging, 2017, 12: 873-896.
30.	Liu C, Xu H, Chen L, et al. Exercise and nutritional intervention for physical function of the prefrail: a systematic review and meta-analysis. J Am Med Dir Assoc, 2022, 23(8): 1431.e1-1431.e19.

1. 龚锋, 邓龙真. 人口老龄化、跨区人口流动与县域经济增长. 中南财经政法大学学报, 2022, (1): 147-160.
2. 谢攀攀. 中国人口老龄化新特点与地区老龄化差异—基于全国人口普查数据的实证分析. 黑龙江人力资源和社会保障, 2022, (13): 27-29.
3. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
4. Lee H, Lee E, Jang IY. Frailty and comprehensive geriatric assessment. J Korean Med Sci, 2020, 35(3): e16.
5. 肖丽萍, 楚伟英, 张志宏, 等. 养老机构老年人营养风险与衰弱状况分析. 中国卫生标准管理, 2020, 11(11): 11-15.
6. 毛国菊. 住院老年人整体衰弱与社会衰弱现状及相关性研究. 沈阳: 中国医科大学, 2021.
7. Daniels R, van Rossum E, de Witte L, et al. Interventions to prevent disability in frail community-dwelling elderly: a systematic review. BMC Health Serv Res, 2008, 8: 278.
8. Shim S, Yoon BH, Shin IS, et al. Network meta-analysis: application and practice using Stata. Epidemiol Health, 2017, 39: e2017047.
9. Vaes AMM, Tieland M, Toussaint N, et al. Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. J Nutr, 2018, 148(5): 712-720.
10. Bauer JM, Verlaan S, Bautmans I, et al. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2015, 16(9): 740-747.
11. Abe S, Ezaki O, Suzuki M. Medium-chain triglycerides in combination with leucine and vitamin D increase muscle strength and function in frail elderly adults in a randomized controlled trial. J Nutr, 2016, 146(5): 1017-1026.
12. Bo Y, Liu C, Ji Z, et al. 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. Clin Nutr, 2019, 38(1): 159-164.
13. Björkman MP, Suominen MH, Kautiainen H, et al. Effect of protein supplementation on physical performance in older people with sarcopenia-a randomized controlled trial. J Am Med Dir Assoc, 2020, 21(2): 226-232.
14. Martínez-Arnau FM, Fonfría-Vivas R, Buigues C, et al. Effects of leucine administration in sarcopenia: a randomized and placebo-controlled clinical trial. Nutrients, 2020, 12(4): 932.
15. Munguia L, Rubio-Gayosso I, Ramirez-Sanchez I, et al. High flavonoid cocoa supplement ameliorates plasma oxidative stress and inflammation levels while improving mobility and quality of life in older subjects: a double-blind randomized clinical trial. J Gerontol A Biol Sci Med Sci, 2019, 74(10): 1620-1627.
16. Kim H, Suzuki T, Kim M, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS One, 2015, 10(2): e0116256.
17. Badrasawi M, Shahar S, Zahara AM, et al. Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial. Clin Interv Aging, 2016, 11: 1675-1686.
18. Tieland M, Dirks ML, van der Zwaluw N, et al. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc, 2012, 13(8): 713-719.
19. Roschel H, Hayashi AP, Fernandes AL, et al. Supplement-based nutritional strategies to tackle frailty: a multifactorial, double-blind, randomized placebo-controlled trial. Clin Nutr, 2021, 40(8): 4849-4858.
20. Kang L, Gao Y, Liu X, et al. Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: a multicenter study in China. Arch Gerontol Geriatr, 2019, 83: 7-12.
21. Peng LN, Cheng YC, Yu PC, et al. Oral nutritional supplement with β-hydroxy-β-methylbutyrate (HMB) improves nutrition, physical performance and ameliorates intramuscular adiposity in pre-frail older adults: a randomized controlled trial. J Nutr Health Aging, 2021, 25(6): 767-773.
22. Walston J, Buta B, Xue QL. Frailty screening and interventions: considerations for clinical practice. Clin Geriatr Med, 2018, 34(1): 25-38.
23. Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing, 2018, 47(2): 193-200.
24. Cesari M, Calvani R, Marzetti E. Frailty in older persons. Clin Geriatr Med, 2017, 33(3): 293-303.
25. Bonnefoy M, Berrut G, Lesourd B, et al. Frailty and nutrition: searching for evidence. J Nutr Health Aging, 2015, 19(3): 250-257.
26. Howard C, Ferrucci L, Sun K, et al. Oxidative protein damage is associated with poor grip strength among older women living in the community. J Appl Physiol (1985), 2007, 103(1): 17-20.
27. Moraes MB, Avgerinou C, Fukushima FB, et al. Nutritional interventions for the management of frailty in older adults: systematic review and meta-analysis of randomized clinical trials. Nutr Rev, 2021, 79(8): 889-913.
28. Yoshimura Y, Wakabayashi H, Yamada M, et al. Interventions for treating sarcopenia: a systematic review and meta-analysis of randomized controlled studies. J Am Med Dir Assoc, 2017, 18(6): 553.e1-553.e16.
29. Dedeyne L, Deschodt M, Verschueren S, et al. Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv Aging, 2017, 12: 873-896.
30. Liu C, Xu H, Chen L, et al. Exercise and nutritional intervention for physical function of the prefrail: a systematic review and meta-analysis. J Am Med Dir Assoc, 2022, 23(8): 1431.e1-1431.e19.

Chinese Journal of Evidence-Based Medicine

Effect of different nutrient interventions on physical function of elderly with frailty: a network meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content