Higher Protein but Not Energy Intake Is Associated With a Lower Prevalence of Frailty Among Community-Dwelling Older Adults in the French Three-City Cohort

Background: The hypothesis that increasing protein and energy intakes may confer protection against frailty has been suggested, although few studies have examined these associations, especially regarding current protein energy recommendations in the older population.Aim: To assess the association between frailty and higher protein and energy intakes.MethodsThe present study is a secondary, cross-sectional analysis of the French Three-City cohort. Participants were community-dwelling older adults aged 65 and over. Frailty was defined as a score of 3/5 among the 5 Fried criteria: weight loss, exhaustion, muscle weakness, slowness, and physical activity. Protein intake was set at a daily intake ≥1 g/kg body weight and optimal energy intake defined as a daily intake ≥30 kcal/kg. Logistic regressions were performed while adjusting for several sociodemographic and clinical variables.Results: The study sample consisted of 1345 participants [mean age (SD) 74.0 (4.9) years], of whom 55 (4.1%) were identified as frail. After adjusting for sociodemographic and clinical variables, higher protein intake was significantly associated with a lower frailty prevalence [odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.19-0.89; P = .024] whereas no significant association was observed between an optimal energy intake and the presence of frailty (OR = 0.70, 95% CI = 0.32-1.55, P = .38).Conclusions: A 1 g/kg protein intake was associated with a lower prevalence of frailty in French community-dwelling older subjects. This observation adds to the literature, suggesting increasing the daily protein intake to at least 1 g/kg for older adults aged 65 and more

Study Design and Rationale of “A Multicenter, Open-Labeled, Randomized Controlled Trial Comparing MIdazolam Versus Morphine in Acute Pulmonary Edema”: MIMO Trial

Purpose: Morphine has been used for several decades in cases of acute pulmonary edema (APE) due to the anxiolytic and vasodilatory properties of the drug. The non-specific depression of the central nervous system is probably the most significant factor for the changes in hemodynamics in APE. Retrospective studies have shown both negative and neutral effects in patients with APE and therefore some authors have suggested benzodiazepines as an alternative treatment. The use of intravenous morphine in the treatment of APE remains controversial. Methods: The MIdazolan versus MOrphine in APE trial (MIMO) is a multicenter, prospective, open-label, randomized study designed to evaluate the efficacy and safety of morphine in patients with APE. The MIMO trial will evaluate as a primary endpoint whether intravenous morphine administration improves clinical outcomes defined as in-hospital mortality. Secondary endpoint evaluation will be mechanical ventilation, cardiopulmonary resuscitation, intensive care unit admission rate, intensive care unit length of stay, and hospitalization length. Conclusions: In the emergency department, morphine is still used for APE in spite of poor scientific background data. The data from the MIMO trial will establish the effect—and especially the risk—when using morphine for APE.Sin financiación2.771 JCR (2017) Q2, 56/128 Cardiac and Cardiovascular Systems, 111/261 Pharmacology and PharmacyUE