Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland.
The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland.
Eur Geriatr Med. 2021 Apr;12(2):303-312. doi: 10.1007/s41999-020-00438-4. Epub 2021 Feb 13.
BACKGROUND: The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. METHODS: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. RESULTS: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. CONCLUSION: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
背景:“老年人肌肉减少症和身体虚弱:多组分治疗策略”(SPRINTT)项目赞助了一项多中心随机对照试验(RCT),旨在确定身体活动和营养干预对预防欧洲社区居住的虚弱老年人移动障碍的影响。我们在此描述 SPRINTT 营养干预的设计和可行性,包括营养干预者用于识别营养不良风险者并进行营养干预的技术。
方法:SPRINTT RCT 从 11 个欧洲国家招募了老年人(≥70 岁)。符合条件的参与者(n=1517)的功能受限通过短体物理表现电池(SPPB 评分 3-9)测量,并且通过 DXA 扫描确定低肌肉质量,但能够在 15 分钟内无需帮助行走 400 米。参与者随访时间长达 3 年。营养干预主要通过个体营养咨询进行。营养目标包括实现每日蛋白质摄入量 1.0-1.2g/kg 体重,能量摄入量 25-30kcal/kg 体重/天,以及血清维生素 D 浓度≥75mmol/L。向 16 个 SPRINTT 研究地点的所有营养干预者发送了关于营养干预方法策略和可行性的调查。
结果:所有研究地点的营养干预者都对调查做出了回应。所有回应者都认为 SPRINTT 营养干预对目标人群是可行的,并且得到了大多数人的欢迎。通过结合访谈、问卷、临床和实验室数据的信息来确定有营养风险的参与者。虽然营养干预主要通过个体营养咨询进行,但也酌情使用了其他辅助方法。
结论:SPRINTT 营养干预是可行的,并能够灵活适应这种异质人群的不同需求。采用的程序来识别有营养不良风险的老年人并设计适当的干预措施可以作为为有移动障碍的社区居住的老年人提供营养干预的模型。
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