Visiting Doctors Program of Medical Home, Seoul, Republic of Korea.
Institute of Social Welfare, Sungkonghoe University, Seoul, Republic of Korea.
Gerontology. 2021;67(5):620-632. doi: 10.1159/000514676. Epub 2021 May 11.
Chronic undernutrition and a homebound state are corelated and are both important components of frailty. However, whether social network intervention combined with protein supplementation is an effective strategy to prevent functional decline among frail older adults is unclear.
150 frail older adults participated in a 3-month, 3-armed, community-based clinical trial and were randomly assigned to one of 3 groups: high-protein supplementation (additional 27 g of protein/day), the Social Nutrition Program (additional 27 g of protein/day and social network intervention), or a control group. Those assigned to the Social Nutrition Program group received individual counseling from 1 dietitian and 1 social worker during 6 home visits and were encouraged to participate in 4 sessions of community-based cooking activities, the social kitchen program. Primary outcomes were changes in Physical Functioning (PF) and the Timed Up and Go (TUG) test and were assessed at 0 months (baseline), 1.5 months (interim), and 3, 6, and 9 months (postintervention).
Compared with the control group, participants in the Social Nutrition Program showed an average improvement of 2.2-3.0 s in the TUG test and this improvement persisted for 3 months after the end of the program (post hoc p ≤ 0.030). The Social Nutrition Program also increased PF by 1.3 points while the control group showed a 1.4 point reduction at the end of the program (post hoc p = 0.045). Improvement in PF and TUG results was primarily observed for the socially frail subgroup of older adults in the Social Nutrition Program group rather than the physically frail subgroup. Frequency of leaving home functioned as a mediator (p = 0.042) and explained 31.2% of the total effect of the Social Nutrition Program on PF change.
Our results indicate that social network intervention combined with protein supplementation can improve both the magnitude and duration of functional status among frail older community-dwelling adults.
慢性营养不良和居家状态相关，且均是衰弱的重要组成部分。然而，社交网络干预联合蛋白质补充是否是预防虚弱老年人功能下降的有效策略尚不清楚。
150 名虚弱老年人参与了一项为期 3 个月的、3 臂、基于社区的临床试验，并被随机分配到以下 3 组中的 1 组：高蛋白补充（每天额外补充 27 克蛋白质）、社会营养计划（每天额外补充 27 克蛋白质和社交网络干预）或对照组。被分配到社会营养计划组的老年人在 6 次家访中接受 1 名营养师和 1 名社会工作者的单独咨询，并被鼓励参加 4 次基于社区的烹饪活动，即社会厨房计划。主要结局是身体机能（PF）和计时起立行走（TUG）测试的变化，分别在 0 个月（基线）、1.5 个月（中期）和 3、6 和 9 个月（干预后）进行评估。
与对照组相比，社会营养计划组参与者 TUG 测试的平均改善为 2.2-3.0 秒，且这种改善在计划结束后 3 个月内持续存在（事后检验 p≤0.030）。社会营养计划还使 PF 增加了 1.3 分，而对照组在计划结束时下降了 1.4 分（事后检验 p=0.045）。PF 和 TUG 结果的改善主要见于社会营养计划组中社会虚弱的老年人亚组，而不是身体虚弱的老年人亚组。离家频率作为中介（p=0.042），解释了社会营养计划对 PF 变化的总效应的 31.2%。
我们的结果表明，社交网络干预联合蛋白质补充可以改善虚弱的社区居住老年人的功能状态的幅度和持续时间。
