Arch Gerontol Geriatr

BACKGROUND: The decline in lean mass, observed in older people, has been frequently associated with frailty. This assumption has scarcely been assessed. This study explored the association between current proposed definitions of low lean mass and the Fried phenotype of frailty. METHODS: Cross-sectional study. Participants admitted to the Toulouse frailty day hospital, with an assessment of body composition, 70 years or older were included consecutively in the study. Low lean mass (LLM), was identified using five international operative definitions. To construct the definitions, muscle mass was assessed using Intelligent Dual Energy X-ray absorptiometry (I-DXA, LUNAR). Frailty was assessed using the Fried criteria. RESULTS: Data from 283 participants, mean age 82 years and 71% of women were analyzed. LLM was identified between 8.5% and 39.2% of the participants according to the different definitions. Frailty was identified in 46.6% of the sample. 9.1%-48.5% of the frail older people had LLM depending on the definition. The highest association between frailty and LLM was observed with the definition proposed by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project [adjusted Odds Ratio 2.64; 95% confidence interval 1.5-4.8]. CONCLUSION: The decline in lean mass is a component of the frailty syndrome but not universally present. Indeed, LLM and frailty were associated and partly overlapped. Future research including longitudinal studies should exploit the added value of combining LLM and frailty measures in preventing disability and other negative health outcomes

The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

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