- Email: [email protected]
SUN-P039: Association Between Sarcopenia and Functional Status Among Older Nursing Home Residents in Bogota, Colombia
S58
Poster
linear regression was estimated using five of the SF-36v2 subscales as dependent variables: physical function (PF), general health (GH), vitality (VT), mental health (MH) and social function (SF), respectively. Patients with normal nutritional status were used as reference group. The model was adjusted for potential confounders. Results: The average age was 82.5 ± 8.0 years, and 63% were women. Malnutrition was present in 26.7% (n = 32), while 48.3% (n = 58) were at risk of malnutrition. The multiple linear regression showed a significant independent associations between GH (β−12.29, 95% CI −22.39 to −2.19, p = 0.01), MH (β −9.22, 95%CI −17.84 to −0.61, p = 0.03) and malnutrition. Conclusion: Approximately 75% of the AG patients were malnourished or at risk of malnutrition which was associated with poorer general and mental health. These results may suggest that malnutrition and risk of malnutrition is associated with lower score on HRQoL, but a larger sample size might be necessary to detect any significant associations with PF, VT and SF. Disclosure of Interest: None declared
SUN-P037 THE EFFECT OF AQUA AEROBICS ON BODY COMPOSITION, STRENGH AND QUALITY OF LIFE IN OLDER WOMEN E. Weir1. 1NHS Lothian, Edinburgh, United Kingdom Rationale: Water-based exercise may be a method to prevent the loss of skeletal muscle mass, strength or physical function in older adults [1]. The study aimed to investigate whether aqua aerobics can improve body composition, strength/ function and quality of life in older adults. Methods: Independent-living adults (>60 y) volunteered to attend 45-min Aqua Aerobic classes once a week for 6 weeks. Bioelectrical impedance analysis measured body composition, strength was measured via hand grip strength and function was assessed by gait speed and Timed Up and Go (TUG) test. Rand36 measured quality of life indices. A paired sample t-test was used to detect changes in the aforementioned parameters before and after the 6-week period. Results: Fourteen women, mean (sd) age 68.9 (5.8) y were recruited. No significant differences were found in body composition, grip strength or function (Table 1). The only significant difference found was regarding the quality of life aspect of role limitations due to emotional problems ( p < 0.05). Only one participant had the characteristics of sarcopenia. Table 1: Changes in anthropometry, body composition, strength and function after 6 weeks of aqua aerobics
2
BMI (kg*m ) %Body fat 2 SMI (kg*m ) Grip Strength (kg) Gait Speed (m/s) Timed Up and Go (s)
Baseline mean (SD) n = 14
Week 6 mean (SD) n = 14
p value
25.5 (4.2) 36 (7.4) 7.78 (0.88) 25.3 (4.7) 0.95 (0.28) 8.45 (1.70)
25.4 (4.3) 36.8 (6.8) 7.55 (1.01) 25.7 (4.3) 1.06 (0.16) 7.84 (2.04)
0.600 0.515 0.421 0.498 0.193 0.300
Notes: BMI: Body Mass Index, SMI: Skeletal Muscle Index
Conclusion: Group classes allow for social interaction, thus improving some aspects of quality of life. It is suggested to repeat the study for a longer duration and increased number of sessions per week.
References [1] Rica R.L., Carneiro R.M.M., Serra A.J. et al. (2013). Geriatr Gerontology Int. 13, 209–214. Disclosure of Interest: None declared
SUN-P038 ESTIMATION OF THE TOTAL ENERGY EXPENDITURE TO PERFORM THE EFFECTIVE REHABILITATION F. Goda1, F. Sakurai1, T. Tamura1, T. Oryu1, H. Tai1, K. Okumura1, M. Yoshio1, Y. Hashimoto1. 1Senri Rehabilitaion Hospital, Osaka, Japan Rationale: Patients admitted to the Rehabilitation Hospital is often leading to weight loss. The purpose of this study was to determine the total energy expenditure (TEE) required to perform the rehabilitation (rehab) of 3 hours a day with maintaining the weight retrospectively. Methods: A total of 179 (mean 73 years old) patients, who received a three hour rehab per day, were analyzed retrospectively. Patients were divided into three groups using the Functional Independence Measurement (FIM) levels (LV) of category of walking at the time of admission. Independence was 55 patients in corresponds to LV6, 7. Modified dependence was 45 patients in corresponds to LV4, 5, which means supervision or minimum assistance. Dependence was 79 patients corresponds to LV1-3, which means moderate, maximum, or total assistance. Metabolic equivalents of rehab; METs (rehab) was calculated from the three hours of activity of rehab that was actually carried out. TEE required for weight maintenance was calculated from the sum of the actual calorie intake and the estimated calorie from increased or decreased body weight. Basal energy expenditure (BEE) was estimated using the HarrisBenedict equations. METs of the sum of rehab and the ADL; METs (rehab + ADL) and activity factor were determined by the following formula. TEE = BEE × activity factor × stress factor = BEE + 1.05 × METs (rehab + ADL) Results:
METs (rehab)
Independence m-Dependence Dependence total
METs (rehab + ADL)
Activity factor
mean
95%CI
mean
95%CI
mean
95%CI
7.0 6.4 5.6 6.2
6.6–7.3 6.0–6.7 5.3–5.9 6.0–6.5
9.1 8.6 8.4 8.6
7.4–10.9 6.9–10.4 7.1–9.7 7.4–9.5
1.45 1.44 1.41 1.43
1.38–1.53 1.35–1.53 1.35–1.47 1.38–1.47
Conclusion: To determine the TEE of patients undergoing rehabilitation, recommended METs (rehab + ADL) and activity factor are 8.5 and 1.5. Disclosure of Interest: None declared
SUN-P039 ASSOCIATION BETWEEN SARCOPENIA AND FUNCTIONAL STATUS AMONG OLDER NURSING HOME RESIDENTS IN BOGOTA, COLOMBIA G. A. Diaz Muñoz1,2, D. Cárdenas1,2, A. Mesa Jimenez1. 1Faculty of Medicine, 2Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
Geriatrics 1 Rationale: Functional disability is closely related to sarcopenia. The objective was to determine the association between sarcopenia and functionality in older adults from nursing homes in Bogota. Methods: This cross sectional study was conducted among subjects aged 65 years and older who lived in four nursing homes in Bogota. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was diagnosed if: calf circumference ≤31 cm, hand grip strength ≤30 kg for men and ≤20 kg for women and gait speed <0.8 m/s in 4 m. The functionality was assessed by the Katz index, ≤5 points was considered with loss of functionality. The association between sarcopenia and functional status was made through comparing the groups between sarcopenia and without sarcopenia. Statistical tests were U-Mann Whitney and Ji2 of Pearson and it was significant p value <0.05. The confusion was controlled by genders. This study was approved by an ethics committee and funded by the El Bosque University. Results: A total of 108 residents (62% women) were studied with a median age of 80.3 years. The prevalence of sarcopenia and loss of functional status was 38.9% and 26.9% respectively. The 12% of residents had both conditions. No association between sarcopenia and functionality was found in the sample. The prevalence of sarcopenia and dependence were distributed equally in both sexes ( p > 0.1). In women, sarcopenia was associated with older age and low functionality was associated with low calf circumference. Conclusion: The prevalence of sarcopenia and dependence is high in the population studied, but no association between these two illnesses was found. Disclosure of Interest: None declared
SUN-P040 ESTIMATION OF FACTORS CONTRIBUTING TO SARCOPENIA IN HIP FRACTURE PATIENTS H. Rosendahl-Riise1, S. Adnanes2, V. S. Aabel2, A. H. Ranhoff1, J. Dierkes2. 1Dept. of Clinical Science, 2Dept. of Clinical Medicine, University of Bergen, Bergen, Norway Rationale: Functional outcomes after a hip fracture are often unsatisfactory, even if the patients have been in relative good age-related health before the fracture. Development of sarcopenia may contribute to this. We wanted to estimate the degree of sarcopenia in patients about two months after a hip fracture and the association with dietary, functional, anthropometric and biochemical measures. Methods: – Observational follow up study in patients ≥65 years with a first hip fracture and who were able to walk independently before the fracture. – Anthropometric and dietary assessment in the hospital, and after the patients returned to their home (after 69 ± 18 d). – Assessment of appendicular muscle mass by bioelectric impedance measurements and calculation of ALM/height2 index as an assessment of sarcopenia, and assessment of hand grip strength (HGS) after the patients returned to their home. Results: We obtained BIA measurements for calculation of ALM and sarcopenia two months after the fracture in n = 25 patients. Average age was 74 ± 10 years, and 19 women and 6 men were included. Fifteen of the patients fulfilled the criteria of
S59 sarcopenia. In the hospital, patients who were sarcopenic about 2 months after the fracture were not different from nonsarcopenic patients in age, weight, BMI, MUAC, energy and protein intake, albumin, hemoglobin or CRP measurements. However, at home, patients with sarcopenia presented with lower energy and protein intake, lower HGS and lower hemoglobin levels. Conclusion: In these relatively healthy hip fracture patients, 60% were sarcopenic about two months after the fracture. Differences in dietary intake and anthropomeric measurements between sarcopenic and non-sarcopenic patients were not evident at the time of the fracture, but about two months later, suggesting that sarcopenia in these patients developed during the recovery period. Persistent low energy and protein intake may contribute to this process. Disclosure of Interest: None declared
SUN-P041 THE IMPACT OF LEUCINE ENRICHED ESSENTIAL AMINO ACID JELLY ON ACTIVITIES OF DAILY LIVING IMPROVEMENT IN OLDER PEOPLE LIVING IN LONG-TERM HEALTH CARE FACILITY H. Wakabayashi1, Y. Karibe2, H. Kobayashi3. 1Department of Rehabilitation Medicine, Yokohama City University Medical Center, 2Nursing home Rehab-park Maioka, Yokohama, 3R&D Planning Department, Ajinomoto Co., Inc., Tokyo, Japan Rationale: To investigate the efficacy of the leucine enriched essential amino acid (EAA) jelly for activities of daily living (ADL) improvement in older people living in long-term health care facility (LHCF). Methods: Controlled before-and-after study was performed in 61 participants aged over 65 years (85.8 ± 7.7 y, 15 males and 46 females) living in LHCF. All participants received nursing care and rehabilitation for 12 weeks. 30 participants consumed one pack of the leucine enriched EAA jelly (30 kcal, EAA 3 g, leucine 1.2 g) per day in addition to their normal diet throughout the study (LEU), and 31 participants did not (CON). The primary outcome was the Functional Independence Measure (FIM) gain and the secondary outcome was the Mini Nutritional Assessment Short-Form (MNA-SF) change. The effects of the supplementation of the EAA jelly were analyzed using two-way repeated measures ANOVA, and presented as mean ± SD changes from baseline after 12 weeks. Results: There were no deference between groups at baseline in age, sex, mean FIM score (LEU: 80.4 ± 25.6; CON: 85.3 ± 27.2), and median MNA-SF score (LEU: 9 [7, 10]; CON: 9 [7, 11]). Two-way repeated measures ANOVA revealed significant group x time interaction in FIM gain (LEU: 4.2 ± 5.8; CON: 1.6 ± 3.4, p = 0.038) as well as MNA-SF change (LEU: 2.1 ± 2.6; CON: 0.7 ± 1.5, p = 0.011), indicating both FIM gain and MNA-SF change were higher in LEU than in CON. Conclusion: Supplementation of the leucine enriched EAA jelly may improve ADL in addition to nutritional status in older people living in LHCF. Disclosure of Interest: H. Wakabayashi Grant/Research Support from: Ajinomoto Co., Inc., Y. Karibe Grant/Research Support from: Ajinomoto Co., Inc., H. Kobayashi Grant/Research Support from: Ajinomoto Co., Inc.
Poster
linear regression was estimated using five of the SF-36v2 subscales as dependent variables: physical function (PF), general health (GH), vitality (VT), mental health (MH) and social function (SF), respectively. Patients with normal nutritional status were used as reference group. The model was adjusted for potential confounders. Results: The average age was 82.5 ± 8.0 years, and 63% were women. Malnutrition was present in 26.7% (n = 32), while 48.3% (n = 58) were at risk of malnutrition. The multiple linear regression showed a significant independent associations between GH (β−12.29, 95% CI −22.39 to −2.19, p = 0.01), MH (β −9.22, 95%CI −17.84 to −0.61, p = 0.03) and malnutrition. Conclusion: Approximately 75% of the AG patients were malnourished or at risk of malnutrition which was associated with poorer general and mental health. These results may suggest that malnutrition and risk of malnutrition is associated with lower score on HRQoL, but a larger sample size might be necessary to detect any significant associations with PF, VT and SF. Disclosure of Interest: None declared
SUN-P037 THE EFFECT OF AQUA AEROBICS ON BODY COMPOSITION, STRENGH AND QUALITY OF LIFE IN OLDER WOMEN E. Weir1. 1NHS Lothian, Edinburgh, United Kingdom Rationale: Water-based exercise may be a method to prevent the loss of skeletal muscle mass, strength or physical function in older adults [1]. The study aimed to investigate whether aqua aerobics can improve body composition, strength/ function and quality of life in older adults. Methods: Independent-living adults (>60 y) volunteered to attend 45-min Aqua Aerobic classes once a week for 6 weeks. Bioelectrical impedance analysis measured body composition, strength was measured via hand grip strength and function was assessed by gait speed and Timed Up and Go (TUG) test. Rand36 measured quality of life indices. A paired sample t-test was used to detect changes in the aforementioned parameters before and after the 6-week period. Results: Fourteen women, mean (sd) age 68.9 (5.8) y were recruited. No significant differences were found in body composition, grip strength or function (Table 1). The only significant difference found was regarding the quality of life aspect of role limitations due to emotional problems ( p < 0.05). Only one participant had the characteristics of sarcopenia. Table 1: Changes in anthropometry, body composition, strength and function after 6 weeks of aqua aerobics
2
BMI (kg*m ) %Body fat 2 SMI (kg*m ) Grip Strength (kg) Gait Speed (m/s) Timed Up and Go (s)
Baseline mean (SD) n = 14
Week 6 mean (SD) n = 14
p value
25.5 (4.2) 36 (7.4) 7.78 (0.88) 25.3 (4.7) 0.95 (0.28) 8.45 (1.70)
25.4 (4.3) 36.8 (6.8) 7.55 (1.01) 25.7 (4.3) 1.06 (0.16) 7.84 (2.04)
0.600 0.515 0.421 0.498 0.193 0.300
Notes: BMI: Body Mass Index, SMI: Skeletal Muscle Index
Conclusion: Group classes allow for social interaction, thus improving some aspects of quality of life. It is suggested to repeat the study for a longer duration and increased number of sessions per week.
References [1] Rica R.L., Carneiro R.M.M., Serra A.J. et al. (2013). Geriatr Gerontology Int. 13, 209–214. Disclosure of Interest: None declared
SUN-P038 ESTIMATION OF THE TOTAL ENERGY EXPENDITURE TO PERFORM THE EFFECTIVE REHABILITATION F. Goda1, F. Sakurai1, T. Tamura1, T. Oryu1, H. Tai1, K. Okumura1, M. Yoshio1, Y. Hashimoto1. 1Senri Rehabilitaion Hospital, Osaka, Japan Rationale: Patients admitted to the Rehabilitation Hospital is often leading to weight loss. The purpose of this study was to determine the total energy expenditure (TEE) required to perform the rehabilitation (rehab) of 3 hours a day with maintaining the weight retrospectively. Methods: A total of 179 (mean 73 years old) patients, who received a three hour rehab per day, were analyzed retrospectively. Patients were divided into three groups using the Functional Independence Measurement (FIM) levels (LV) of category of walking at the time of admission. Independence was 55 patients in corresponds to LV6, 7. Modified dependence was 45 patients in corresponds to LV4, 5, which means supervision or minimum assistance. Dependence was 79 patients corresponds to LV1-3, which means moderate, maximum, or total assistance. Metabolic equivalents of rehab; METs (rehab) was calculated from the three hours of activity of rehab that was actually carried out. TEE required for weight maintenance was calculated from the sum of the actual calorie intake and the estimated calorie from increased or decreased body weight. Basal energy expenditure (BEE) was estimated using the HarrisBenedict equations. METs of the sum of rehab and the ADL; METs (rehab + ADL) and activity factor were determined by the following formula. TEE = BEE × activity factor × stress factor = BEE + 1.05 × METs (rehab + ADL) Results:
METs (rehab)
Independence m-Dependence Dependence total
METs (rehab + ADL)
Activity factor
mean
95%CI
mean
95%CI
mean
95%CI
7.0 6.4 5.6 6.2
6.6–7.3 6.0–6.7 5.3–5.9 6.0–6.5
9.1 8.6 8.4 8.6
7.4–10.9 6.9–10.4 7.1–9.7 7.4–9.5
1.45 1.44 1.41 1.43
1.38–1.53 1.35–1.53 1.35–1.47 1.38–1.47
Conclusion: To determine the TEE of patients undergoing rehabilitation, recommended METs (rehab + ADL) and activity factor are 8.5 and 1.5. Disclosure of Interest: None declared
SUN-P039 ASSOCIATION BETWEEN SARCOPENIA AND FUNCTIONAL STATUS AMONG OLDER NURSING HOME RESIDENTS IN BOGOTA, COLOMBIA G. A. Diaz Muñoz1,2, D. Cárdenas1,2, A. Mesa Jimenez1. 1Faculty of Medicine, 2Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
Geriatrics 1 Rationale: Functional disability is closely related to sarcopenia. The objective was to determine the association between sarcopenia and functionality in older adults from nursing homes in Bogota. Methods: This cross sectional study was conducted among subjects aged 65 years and older who lived in four nursing homes in Bogota. According to the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia was diagnosed if: calf circumference ≤31 cm, hand grip strength ≤30 kg for men and ≤20 kg for women and gait speed <0.8 m/s in 4 m. The functionality was assessed by the Katz index, ≤5 points was considered with loss of functionality. The association between sarcopenia and functional status was made through comparing the groups between sarcopenia and without sarcopenia. Statistical tests were U-Mann Whitney and Ji2 of Pearson and it was significant p value <0.05. The confusion was controlled by genders. This study was approved by an ethics committee and funded by the El Bosque University. Results: A total of 108 residents (62% women) were studied with a median age of 80.3 years. The prevalence of sarcopenia and loss of functional status was 38.9% and 26.9% respectively. The 12% of residents had both conditions. No association between sarcopenia and functionality was found in the sample. The prevalence of sarcopenia and dependence were distributed equally in both sexes ( p > 0.1). In women, sarcopenia was associated with older age and low functionality was associated with low calf circumference. Conclusion: The prevalence of sarcopenia and dependence is high in the population studied, but no association between these two illnesses was found. Disclosure of Interest: None declared
SUN-P040 ESTIMATION OF FACTORS CONTRIBUTING TO SARCOPENIA IN HIP FRACTURE PATIENTS H. Rosendahl-Riise1, S. Adnanes2, V. S. Aabel2, A. H. Ranhoff1, J. Dierkes2. 1Dept. of Clinical Science, 2Dept. of Clinical Medicine, University of Bergen, Bergen, Norway Rationale: Functional outcomes after a hip fracture are often unsatisfactory, even if the patients have been in relative good age-related health before the fracture. Development of sarcopenia may contribute to this. We wanted to estimate the degree of sarcopenia in patients about two months after a hip fracture and the association with dietary, functional, anthropometric and biochemical measures. Methods: – Observational follow up study in patients ≥65 years with a first hip fracture and who were able to walk independently before the fracture. – Anthropometric and dietary assessment in the hospital, and after the patients returned to their home (after 69 ± 18 d). – Assessment of appendicular muscle mass by bioelectric impedance measurements and calculation of ALM/height2 index as an assessment of sarcopenia, and assessment of hand grip strength (HGS) after the patients returned to their home. Results: We obtained BIA measurements for calculation of ALM and sarcopenia two months after the fracture in n = 25 patients. Average age was 74 ± 10 years, and 19 women and 6 men were included. Fifteen of the patients fulfilled the criteria of
S59 sarcopenia. In the hospital, patients who were sarcopenic about 2 months after the fracture were not different from nonsarcopenic patients in age, weight, BMI, MUAC, energy and protein intake, albumin, hemoglobin or CRP measurements. However, at home, patients with sarcopenia presented with lower energy and protein intake, lower HGS and lower hemoglobin levels. Conclusion: In these relatively healthy hip fracture patients, 60% were sarcopenic about two months after the fracture. Differences in dietary intake and anthropomeric measurements between sarcopenic and non-sarcopenic patients were not evident at the time of the fracture, but about two months later, suggesting that sarcopenia in these patients developed during the recovery period. Persistent low energy and protein intake may contribute to this process. Disclosure of Interest: None declared
SUN-P041 THE IMPACT OF LEUCINE ENRICHED ESSENTIAL AMINO ACID JELLY ON ACTIVITIES OF DAILY LIVING IMPROVEMENT IN OLDER PEOPLE LIVING IN LONG-TERM HEALTH CARE FACILITY H. Wakabayashi1, Y. Karibe2, H. Kobayashi3. 1Department of Rehabilitation Medicine, Yokohama City University Medical Center, 2Nursing home Rehab-park Maioka, Yokohama, 3R&D Planning Department, Ajinomoto Co., Inc., Tokyo, Japan Rationale: To investigate the efficacy of the leucine enriched essential amino acid (EAA) jelly for activities of daily living (ADL) improvement in older people living in long-term health care facility (LHCF). Methods: Controlled before-and-after study was performed in 61 participants aged over 65 years (85.8 ± 7.7 y, 15 males and 46 females) living in LHCF. All participants received nursing care and rehabilitation for 12 weeks. 30 participants consumed one pack of the leucine enriched EAA jelly (30 kcal, EAA 3 g, leucine 1.2 g) per day in addition to their normal diet throughout the study (LEU), and 31 participants did not (CON). The primary outcome was the Functional Independence Measure (FIM) gain and the secondary outcome was the Mini Nutritional Assessment Short-Form (MNA-SF) change. The effects of the supplementation of the EAA jelly were analyzed using two-way repeated measures ANOVA, and presented as mean ± SD changes from baseline after 12 weeks. Results: There were no deference between groups at baseline in age, sex, mean FIM score (LEU: 80.4 ± 25.6; CON: 85.3 ± 27.2), and median MNA-SF score (LEU: 9 [7, 10]; CON: 9 [7, 11]). Two-way repeated measures ANOVA revealed significant group x time interaction in FIM gain (LEU: 4.2 ± 5.8; CON: 1.6 ± 3.4, p = 0.038) as well as MNA-SF change (LEU: 2.1 ± 2.6; CON: 0.7 ± 1.5, p = 0.011), indicating both FIM gain and MNA-SF change were higher in LEU than in CON. Conclusion: Supplementation of the leucine enriched EAA jelly may improve ADL in addition to nutritional status in older people living in LHCF. Disclosure of Interest: H. Wakabayashi Grant/Research Support from: Ajinomoto Co., Inc., Y. Karibe Grant/Research Support from: Ajinomoto Co., Inc., H. Kobayashi Grant/Research Support from: Ajinomoto Co., Inc.