Author(s): MONSEGUE, A., DOMIC, J., KRAMER, C.S., MORWANI-MAGNANI, J., WILMS, E.J.C., VAN DER HAIJDEN, M.H.M., SINGH-POVEL, C.M., BEEKMAN, M., DEELEN, J., GROOTSWAGERS, P., VAN LOON, L.J.C., DE GROOT, L.C.P.G.M., SLAGBOOM, P.E., VERDIJK, L.B., Institution: MAASTRICHT UNIVERSITY, Country: NETHERLANDS, Abstract-ID: 1070

INTRODUCTION:
Although targeted lifestyle interventions improve muscle outcomes in older adults, evidence is largely derived from narrowly defined healthy or clinical populations, leaving generally health-compromised older adults understudied. The present study assessed the effects of a multimodal lifestyle intervention on muscle mass, strength, and physical functioning across various groups of health-compromised older adults with common age-related impairments.
METHODS:
In a non-randomized, parallel group, pre-post design, 92 older adults (71 [CI: 69, 72] y) with one of 3 common age-related impairments were included: 1) metabolically-compromised (MetC), based on MetaboHealth(1) score; 2) mobility-compromised (MobC), based on walking aid use or 5-times chair-stand test (5CST) performance; and 3) total knee replacement patients (TKR). All participants underwent a 12-wk supervised, progressive, high-intensity (80% 1RM), resistance exercise training program on leg press, leg extension, cable row, shoulder press, chest press, and lat pull machines, 3x/wk. They also received daily nutritional support (45g Nutri Whey Isolate, 5.5 g Vivinal GOS, 800 IU vitamin D, 366 mg calcium) and dietary counselling. Pre- and post-intervention assessments included DXA-derived appendicular lean mass (ALM) and body fat, one-repetition maximum (1RM) strength tests, the Short Physical Performance Battery (SPPB), 5CST, 6-min walking test (6MWT), Timed Up-and-Go (TUG), and the Short-Form Sarcopenia Quality-of-Life questionnaire (SF-SarQoL). Data are EMM or change in z-scores (6MWT, 1RM) with [95% CI], and were analysed by linear mixed models.
RESULTS:
ALM increased over time from 22.3 [21.7, 22.9] to 22.8 [22.1, 23.4] kg, with no differences between groups (P-time<0.001, P-interaction [P-int]=0.910). Body fat mass did not change. The SF-SarQoL score (49 [46, 52] to 60 [56, 63]), SPPB (9.4 [9.0, 9.7] to 10.4 [10.0, 10.7]), and TUG (9.0 [8.5, 9.5] to 8.2 [7.7, 8.7] s) improved over time, with no group differences (all P-time<0.001, P-int≥0.553). The 6MWT improved in MetC (0.34 [0.15, 0.53], P=0.004) and TKR (0.66 [0.43, 0.89], P<0.001), but not in MobC (0.16 [0.01, 0.32], P=0.153, P-int=0.003). In contrast, the 5CST improved from 19.9 [18.2, 21.6] to 14.8 [13.1, 16.6] s in MobC (P<0.001, P-int=0.005), but not in TKR (from 15.3 [13.0, 17.6] to 14.0 [11.5, 16.4] s, P=0.288) or MetC (from 12.7 [10.9, 14.4] to 11.0 [9.1, 12.8] s, P=0.091). All upper and lower body 1RMs increased over time in all groups (delta z-score range: 0.30-1.45, P-time<0.001). Between-group differences (P-int≤0.004) were only observed for leg extension (highest in TKR), and shoulder press (highest in MetC).
CONCLUSION:
A supervised lifestyle intervention with high-intensity resistance exercise training and protein-based nutritional support improves muscle mass, strength, and physical functioning in health-compromised older adults, irrespective of underlying impairments.
1: Deelen et al, Nat Commun, 2019.