#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Active approach to acute hospitalised geriatric patient for preventing muscle loss and self-sufficiency


Authors: Z. Dědková;  P. Hegerová;  B. Jurašková;  L. Sobotka
Published in: Geriatrie a Gerontologie 2017, 6, č. 2: 69-74
Category: Original Article/Study

Overview

Background & aims:
Any acute disease in elderly patients often leads to the loss of muscle mass and self-sufficiency. Recovery of muscle tissue is difficult and thus an acute illness can lead to the need of other persons help. The aim of our study was to determine whether an early physiotherapy and nutritional supplementation affects the development of sarcopenia and patient´s self-sufficiency during the acute illness.

Methods:
200 patients over 78 years of age, admitted to geriatric department with an acute illness were enrolled in a prospective, controlled study. Patients were randomized to the control and the intervention group. The intervention consisted of providing nutritional supplements and simultaneously an intensive rehabilitation therapy. Patients were followed for 2 years after discharge.

Results:
Nutritional supplements usage led to an increased daily total energy and protein intake, while the daily intake of normal diet was not reduced. Combination of nutritional support and physiotherapy prevented the loss of muscle mass and muscle strength. Self-sufficiency in the intervention group showed a smaller decline than in the control group during the two-year follow-up period.

Conclusion:
The results of our prospective randomized study have shown that early administration of nutrition supplements together with an early rehabilitation mitigate the loss of muscle mass and muscle strength in acutely admitted older patients and thus prolongs the period of self-sufficiency.

KEYWORDS:
geriatric patient – acute illness – early nutritional support – early rehabilitation – self-sufficiency – muscle mass


Sources

1. Jansen I, Shepard DS, Katzmarzyk PT, et al. The healthcare costs of sarcopenia in the United States. J A Geriatr Soc 2004; 52(1): 80–85.

2. Sobotka L. Vliv malnutrice na průběh akutního onemocnění u gerontologického nemocného. Ces ger rev 2003; 2003(1): 32–35.

3. Starke J, Schneider H, Alteheld B, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30(2): 194–201.

4. Paddon-Jones D, Sheffield-Moore M, Urban RJ, et al. Essential amino acid and carbohydrate supplementation ameliorates muscle protein loss in humans during 28 days bedrem. J Clin Endocrin Metab 2004; 89(9): 4351–4358.

5. Ferrando AA, Tipton KD, Bamman MM, et al. Resistance exercise maintains skeletal muscle protein synthesis during bed rest. J app Physiol 1997; 82(3): 807–810.

6. Kortebein P, Ferrando A, Lombeida J, et al. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA 2007; 297(16): 1772–1774.

7. Soenen S, Rayner ChK, Jones KL, et al. The ageing gastrointestinal tract. Cur Opin Clin Nutr Metab Care 2016; 19(1): 12–18.

8. Sobotka L. Basics in clinical nutrition. 4. vyd. Praha: Galén 2011.

9. Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14(8): 542–559.

10. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39(4): 412–423.

11. Dickinson JM, Volpi E, Rasmussen BB. Exercise and nutrition to target protein synthesis impairments in aging skeletal muscle. Exerc Sport Scien Rev 2013; 41(4): 216–223.

12. Glover EI, Phillips SM, Oates BR, et al. Immobilization induces anabolic resistance in human myofibrillar protein synthesis with low and high dose amino acid infusion. J Physiol 2008; 586(24): 6049–6061.

13. Breen L, Stokes KA, Churchward Venne TA, et al. Two weeks of reduced activity decreases leg lean mass and induces „anabolic resistance“ of myofibrillar protein synthesis in healthy elderly. J Clin Endocrin Metab 2013; 98(6): 2604–2612.

14. Matějovská Kubešová H. Prevence osteoporózy a sarkopenie. Ger Geront 2013; 2(4): 213–215.

15. Fiatarone MA, Marks EC, Ryan ND, et al. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA 1990; 263(22): 3029–3034.

Labels
Geriatrics General practitioner for adults Orthopaedic prosthetics
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#