Division of Human Nutrition and Health, Wageningen University and Research, The Netherlands.
Food, Health and Consumer Research, Wageningen Food and Biobased Research, The Netherlands.
J Gerontol A Biol Sci Med Sci. 2021 Nov 15;76(12):2204-2212. doi: 10.1093/gerona/glab104.
The ProMuscle in Practice intervention, comprising resistance exercise and an increased protein intake, was effective in improving muscle strength, lean body mass, and physical functioning in older adults aged 65 years and older (N = 168). However, a heterogeneous response to such interventions is common. Therefore, we explored the differences in responsiveness to the intervention in subgroups based on demographic characteristics and mobility-impairing disorders.
Multiple regression analyses were performed to study mean changes between baseline and 12 weeks on the Short Physical Performance Battery, chair rise test, lean body mass, knee extension strength, leg press strength, and leg extension strength. The interaction term Treatment × Subgroup was included to study differences in effects between subgroups. Subgroups comprised age (≤75 vs >75 years), sex (men vs women), presence of frailty, presence of sarcopenia, and presence of osteoarthritis.
A significant interaction effect including age was found on lean body mass (β = -0.8; 95% CI: -1.5, -0.2), favoring participants aged 75 years and younger. A significant interaction effect including sex was found on leg press strength (β = 15.5; 95% CI: 0.6, 30.3), favoring women. Participants with or without frailty, sarcopenia, or osteoarthritis responded equally to the intervention in terms of absolute effects.
Participants aged 75 years and younger and women benefited to a great extent from the intervention, as they improved significantly on nearly every outcome. Effects in participants with and without a mobility-impairing disorder were comparable, indicating that the intervention is suitable for both groups.
ProMuscle 在实践中的干预措施，包括阻力运动和增加蛋白质摄入，在改善 65 岁及以上老年人的肌肉力量、瘦体重和身体机能方面是有效的（N=168）。然而，对于这种干预措施的反应存在异质性是很常见的。因此，我们根据人口统计学特征和行动障碍障碍，探索了基于亚组对干预的反应差异。
采用多元回归分析研究了基线至 12 周期间短体适能电池、椅子上升试验、瘦体重、膝关节伸展力量、腿推力量和腿伸力量的平均变化。包括治疗与亚组的交互项，以研究亚组之间的效果差异。亚组包括年龄（≤75 岁与>75 岁）、性别（男性与女性）、是否存在衰弱、是否存在肌肉减少症、是否存在骨关节炎。
在瘦体重方面发现了包括年龄的显著交互作用（β=-0.8；95%CI：-1.5，-0.2），这有利于年龄在 75 岁及以下的参与者。在腿推力量方面发现了包括性别的显著交互作用（β=15.5；95%CI：0.6，30.3），这有利于女性。是否存在衰弱、肌肉减少症或骨关节炎的参与者在绝对效果方面对干预的反应相同。
年龄在 75 岁及以下和女性的参与者从干预中获益极大，因为他们在几乎所有的结果上都有显著的改善。有或没有行动障碍障碍的参与者的效果相当，这表明该干预措施适用于这两个群体。
