SUN-P047: The Acute Effects of Tryptophan Enriched Whey Protein on Cognitive Functions in Older Adults with Mild Cognitive Impairment

S70

MNA (0–30)¶ BMI (kg/m2)¶ FFMI (kg/m2)¶ Arm (cm) Calf (cm) Waist (cm)

Poster Controls

MCI

AD

pvalue

26.3 ± 2.0 27.0 ± 4.7 17.7 ± 2.6 29.6 ± 3.4 36.8 ± 3.4 92.3 ± 13.2

25.1 ± 2.7a 25.8 ± 3.8 17.3 ± 2.1 28.5 ± 3.2 35.5 ± 3.0 92.4 ± 11.9

23.5 ± 3.0a,b 24.9 ± 3.8a 16.9 ± 2.2a 28.1 ± 3.0 35.7 ± 3.5 88.8 ± 11.6

0.000 0.021 0.038 0.274* 0.323 0.128

All data in mean ± SD ¶ Main effect for diagnosis a different from controls; bdifferent from MCI p < 0.05 *Interaction diagnosis* gender p = 0.055

Conclusion: Patients with MCI and AD have a lower MNA score, and BMI and FFMI compared to controls. We are currently studying how nutritional status and body composition contribute to progression of cognitive decline. Disclosure of Interest: A. Doorduijn Grant/Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14-004) and industry (Nutricia Research, Friesland Campina and DSM), O. Van de Rest Grant/Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14004) and industry (Nutricia Research, Friesland Campina and DSM), S. Boesveldt Grant/Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14-004) and industry (Nutricia Research, Friesland Campina and DSM), W. Van der Flier Grant/Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14-004) and industry (Nutricia Research, Friesland Campina and DSM), M. Visser Grant/ Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14-004) and industry (Nutricia Research, Friesland Campina and DSM), M. De van der Schueren Grant/Research Support from: This project is funded by the “Food, Brain and Cognition” program of NWO (057-14-004) and industry (Nutricia Research, Friesland Campina and DSM).

SUN-P046 DEPRESSED MOOD AND COGNITIVE FUNCTIONS IN PATIENTS WITH CANCER ARE ASSOCIATED WITH ALTERATIONS IN TRYPTOPHAN METABOLISM B. S. Van Der Meij1,2,3 *, C. K. Lieben1, N. E. Deutz1, R. E. Rodriguez4, F. Koeman1, T. C. Smit1, M. P. Engelen5. 1 Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, United States, 2Faculty of Health Sciences and Medicine, Bond University, God Coast, 3 Nutrition and Dietetics, Mater Group, Brisbane, Australia, 4 Division of Hematology/Oncology, Scott and White Memorial Hospital, College Station, United States, 5Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, Australia Rationale: Depression and cognitive deficits have been observed in patients with cancer. Although degradation of tryptophan (TRP; precursor of serotonin) has been detected in cancer, the exact association between whole body TRP metabolism and neuropsychological functions in advanced cancer remains unclear. Methods: In 16 patients with solid tumours (C) and 16 age and gender matched healthy controls, the rates of appearance (Ra) and clearance of TRP were assessed by primed continuous infusion of L-[indole-2H5]TRP. Plasma amino acid profile was analyzed to measure plasma TRP level, and ratio plasma TRP to Large neutral amino acids (LNAA = sum of tyrosine,

phenylalanine, isoleucine, leucine and valine) calculated as marker of TRP uptake into the brain. Mood was assessed by the Hospital Anxiety and Depression Score, and cognition by a test battery consisting of the Auditory Verbal Learning, Verbal Fluency, Trail Making, and Stroop tests. Plasma amino acid levels and isotope enrichments were measured by LC-MS/MS. Statistics were done by unpaired t-tests and Pearson’s correlation. Results: Depression scores were higher in C (5.0 vs 2.6, P < 0.05), but cognitive outcomes were comparable between the groups. In C, the depression scores correlated negatively with plasma TRP (r = −0.69, P < 0.01) and positively with TRP clearance rate (r = 0.60, P < 0.05). Additionally, we found that only in C, TRP Ra was associated with word fluency (r = 0.70, P < 0.01), processing speed (TMT completion time; r < −0.54, P < 0.05), and verbal learning capacity and memory (immediate and delayed recall, learning rate and recognition; r ≥ 0.63, P ≤ 0.01). No relationship was found between plasma TRP/ LNAA ratio and mood or cognition. Conclusion: These findings suggest that an imbalance in TRP metabolism plays a role in the depressive symptoms in patients with cancer and may increase their risk of developing cognitive deficits. Disclosure of Interest: B. Van Der Meij Grant/Research Support from: ESPEN Research Fellowship, C. Lieben: None declared, N. Deutz: None declared, R. Rodriguez: None declared, F. Koeman: None declared, T. Smit: None declared, M. Engelen: None declared.

SUN-P047 THE ACUTE EFFECTS OF TRYPTOPHAN ENRICHED WHEY PROTEIN ON COGNITIVE FUNCTIONS IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT C. K. Lieben1 *, N. E. Deutz1, A. Salentijn1,2, M. P. Engelen1. 1 Health and Kinesiology, Texas A&M University, College Station, United States, 2Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, Netherlands Rationale: The essential amino acid tryptophan (TRP, precursor of serotonin and kynurenine) regulates mood and memory. Since aging modifies the serotonergic metabolism and TRP enriched protein meals have mood and memory enhancing properties, our hypothesis is that optimizing TRP availability via intake of α-lactalbumin (ALAC) diminishes cognitive deficits in older adults with mild cognitive impairment (MCI). Methods: This randomized placebo controlled crossover study examines the acute effects of ALAC on cognitive functions in healthy older adults with and without MCI. Participants, older than 55 years were stratified by cognitive complaints and a Montreal Cognitive Assessment (MoCA) score of less than 26 in a MCI group (n = 19) and an age and gender matched control group (CON; n = 18). Plasma amino acid levels were measured prior to and 3h after intake of the protein mixtures (Davisco) containing ALAC or Whey protein as placebo (4.8 vs 2.7 g TRP/ 100 g product, respectively) to determine changes in TRP and TRP/large neutral amino acids (LNAA) ratio. Subsequently, attention, executive and memory functions (using AVLT, VFT, TMT, STROOP, and PASAT assessments) were evaluated in both groups. Statistics were done by two-way analysis of variance.

Geriatrics 1 Results: Baseline characteristics, plasma TRP levels and TRP/ LNAA ratio were similar between the groups. Independent of the group, each protein affected TRP levels and TRP/LNAA ratio differently ( p < 0.01) as ALAC increased TRP/LNAA ratio by 92% and 100%, while Whey induced an increase of 7% and 18% in both CON and MCI group, respectively. Although the MCI group performed worse on all cognitive tests relative to the CON group ( p < 0.05), cognitive outcomes after ALAC intake did not differ from Whey. Conclusion: These findings indicate that a TRP enriched dietary intake has no acute beneficial effects on cognitive performance in older adults with MCI. Disclosure of Interest: None declared.

SUN-P048 WHAT DO NURSES LEARN ABOUT MALNUTRITION IN OLDER ADULTS? D. Eglseer1 *, S. Schüssler1, I. Kravanja1, C. Lohrmann1. 1 Institute of Nursing Science, Medical University Graz, Graz, Austria Rationale: Evidence-based interventions for malnourished older adults are rarely implemented in daily clinical practice. One main reason may be the lack of sufficient nutritional knowledge of nurses. Therefore, this study aimed at determining the provision and content of malnutrition education in basic nursing education across European countries. Methods: This cross-sectional study is part of the European project Malnutrition in the Elderly Knowledge Hub (MaNuEL). Based on an existing questionnaire, an online-survey questionnaire was developed by experts in the field of malnutrition. In January 2017, the online-survey link was emailed to 926 nursing education institutions in 31 European countries. The software tool “SurveyMonkey” was used for the survey and SPSS for descriptive data analysis. Results: 86.3% of the institutions stated offering general nutrition education. In 73%, malnutrition education in older adults is part of the education. The most frequently mentioned topics were malnutrition screening (70.8%), causes (67.2%) and consequences (68.7%) of malnutrition. Rarely reported contents were the responsibilities of various professions in nutritional support (35.1%) as well as the cooperation in multidisciplinary nutrition support teams (28.2%). In more than half of the institutions, malnutrition is taught by nurses and not by nutrition professionals. Conclusion: Malnutrition in older adults is, for the most part, integrated in basic nursing education. However, the multidisciplinary approach is hardly covered in the respective courses. Furthermore, (mal)nutrition education is often in non-nutrition-professional’s hands. This might be a reason why adequate nutritional support is not applied in clinical practice to a satisfying degree. Adaptations of existing (mal)nutrition education courses for nurses in European countries seem to be necessary. Disclosure of Interest: None declared.

S71 SUN-P049 NORDIC HEALTHY DIET AND MORTALITY IN A COHORT OF 70 YEAR-OLD SWEDES: WHAT IS THE CONTRIBUTION OF DAIRY INTAKE? E. Rothenberg1 *, G. Tognon2, L. Lissner2, M. Petrolo2, V. Sundh2. 1 Food and Meal Science, Kristianstad University, 2Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Sahlgrenska Academy, Gothenburg, Sweden Rationale: Several definitions of the Nordic Healthy Diet have been proposed, but there is no consensus on the role of dairy products. We aim to study the impact of the Nordic diet on allcause mortality in a population of 70 year-olds, exploring different versions of a Nordic Healthy Diet Score (NHDS) with focus on the specific role of key dairy products. Methods: Cox proportional hazard models, adjusted for potential confounders, were used to assess the prediction of all-cause mortality using two NHDS definitions (calculated either including low-fat or without dairy products). In separate Cox models, cheese intake and the combined intakes of milk, soured milk and unsweetened yoghurt were tested as well as intake of fat from these two sources. Results: Neither of the standard versions of NHDS was associated with mortality. However, cheese intake was protective of total mortality, whereas milk products (including soured milk and unsweetened yoghurt) predicted increased risk of mortality. Cheese fat intake was also inversely associated with mortality, whereas fat from the other dairy products positively predicted the outcome only when the model was adjusted by energy intake. Conclusion: The NHDS, as previously defined, was not associated with all-cause mortality in this population of elderly[GT1] Swedes. Intake of milk, soured milk and/or unsweetened yoghurt was positively associated with all-cause mortality whereas cheese intake was inversely associated with this outcome. Disclosure of Interest: None declared.

SUN-P050 INDIVIDUAL VARIANCE IN RESTING METABOLIC RATE AND ENERGY BALANCE IN GERIATRIC OUTPATIENTS WITH MOBILITY PROBLEMS E. M. Reijnierse1 *, S. Verlaan2, M. C. Trappenburg2,3, C. G. Meskers4,5, M. A. de van der Schueren6,7, A. B. Maier1,5. 1 Department of Medicine and Aged Care, University of Melbourne, Melbourne, Australia, 2Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, 3Department of Internal Medicine, Amstelland Hospital, Amstelveen, 4Department of Rehabilitation Medicine, VU University Medical Center, 5 Department of Human Movement Sciences, MOVE Research Institute, Vrije Universiteit, 6Department of Internal Medicine, Section of Nutrition and Dietetics, VU University Medical Center, Amsterdam, 7Department of Nutrition and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, Netherlands Rationale: In clinical practice, optimization of physical and nutritional intervention (“tailored therapy”) requires patient specific data on energy expenditure and nutritional intake