Physical Frailty Clinical Trial
Official title:
Effects of High-protein Diet Combined With Exercise to Counteract Frailty in Pre-frail and Frail Community-dwelling Older Adults: a Three-arm Randomized Controlled Trial
The purpose of this study is to determine the effects of interventions with high-protein diet alone or in combination with resistance training on muscle mechanical function (muscle power and strength), frailty status, functional performance, muscle mass and quality of life.
Status | Recruiting |
Enrollment | 150 |
Est. completion date | June 1, 2021 |
Est. primary completion date | June 1, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 80 Years and older |
Eligibility |
Inclusion Criteria: - Community-dwelling adults = 80 years - Pre-frail or frail (evaluated by the physical frailty questionnaire, SHARE-FI75+) - Intact cognitive function (Mini Mental State Evaluation =4) - Medically stable evaluated by medical screening including blood sample - Able to participate in group-based exercise without personal assistance - Able to understand, read and write Danish Exclusion Criteria: - Allergic/ intolerant to the interventions (kidney diseases, lactose intolerance etc.) - On a weight losing diet |
Country | Name | City | State |
---|---|---|---|
Denmark | University of Southern Denmark | Odense |
Lead Sponsor | Collaborator |
---|---|
University of Southern Denmark | Arla Foods, Metropolitan University College, Municipality of Odense, Denmark |
Denmark,
Bechshøft RL, Malmgaard-Clausen NM, Gliese B, Beyer N, Mackey AL, Andersen JL, Kjær M, Holm L. Improved skeletal muscle mass and strength after heavy strength training in very old individuals. Exp Gerontol. 2017 Jun;92:96-105. doi: 10.1016/j.exger.2017.03.014. Epub 2017 Mar 28. — View Citation
Park Y, Choi JE, Hwang HS. Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2018 Nov 1;108(5):1026-1033. doi: 10.1093/ajcn/nqy214. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Cognitive function | The Digit Symbol Substitution Test | Baseline and 4-months follow-up | |
Other | Gender | Gender (male female) | Baseline | |
Other | Age | Age (years) | Baseline | |
Other | Education | Self-report education will be assessed as number of years spent in school and maximum level of education achieved. | Baseline | |
Other | Marital status | Marital status will be evaluated as self-report. | Baseline | |
Other | Depression | depression will be evaluated with validated questionnaire at baseline (Geriatric Depression | Baseline | |
Other | Incontinence | Incontinence will be evaluated with the International Consultation on Incontinence Questionnaire (ICIQ) questionnaire at baseline (max score 21) | Baseline | |
Other | Chronic conditions | Number and type of chronic conditions will be assessed as self-report | Baseline | |
Other | Use of medicine | Direct count of name and dose of medicines performed under medical screening. The participant will be asked to bring the medicines. | Baseline | |
Primary | Changes from baseline lower leg muscle power at 4 months | Lower leg muscle power will be assessed unilaterally using the Nottingham Leg Rig | Baseline and 4-month follow-up | |
Secondary | Changes from baseline physical frailty status at 4 months | Changes in frailty status will be evaluated by the physical frailty questionnaire (SHARE-FI75+) and the slightly modified version of the Frailty Phenotype assessment tool developed by Fried. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline countermovement jump muscle power at 4 months | Weight-bearing multi-joint motor task, countermovement jump, with a linear encoder. | Baseline and 4-month follow-up | |
Secondary | Changes from baseline leg press and handgrip muscle strength at 4 months | Lower limb muscle strength will be measured during a maximal voluntary isometric leg press test (MVC). Subjects are seated in a custom-built unilateral leg press device (knee and ankle angles of 120 and 90, respectively) while pushing against a fixed instrumented force plate as hard and fast as possible with the dominant leg against. Muscle strength, contractile Rate of Force Development (RFD) and impulse will be determined in the trial with the highest resultant peak force. Handgrip: Maximal isometric handgrip strength will be assessed unilaterally using a handheld dynamometer |
Baseline and 4-month follow-up | |
Secondary | Changes from baseline Short Physical Performance Battery test at 4 months | Physical function will be measured with the Short Physical Performance Battery (SPPB) which consists of three items (balance, 3 or 4 meters walking and repeated chair rise). Score ranges from 0-12 (each item has a score between 0 and 4). | Baseline and 4-month follow-up | |
Secondary | Eating Symptom Questionnaire | Evaluated by a validated eating ability questionnaire. For each symptom participant range from none to severe. | Baseline | |
Secondary | Risk of Dysphagia | Evaluated by a validated questionnaire, the EAT-10. Resulting in a score ranging from 0-40 | Baseline | |
Secondary | Appetite | Evaluated by a validated questionnaire the Simplified Nutritional Appetite Questionnaire. Score range from 4-20. | Baseline | |
Secondary | Changes from baseline anthropometry waist and hip circumference at 4 months | Waist and hip circumference (cm) will be measured using a standard ruler. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline body weight at 4 months | Body weight will be measured to using a transportable scale. Participants will be measured without shoes and wearing light clothing. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline lean and fat mass at 4 months | Changes in lean mass and fat mass will be estimated by Bioelectrical Impedance Analysis. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline lean and fat mass and bone mineral density) to 4 months | Changes in body composition (lean and fat mass and bone mineral density) will be measured by Dual-energy X-ray Absorpmetry. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline Health-related quality of life to 4 months | Health-related quality of life questionnaires (EQ-5D-3L and SF-12) will be used. Scores range from 11111-33333 and 0-100, respectively. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline pain to 4 months | Pain will be assessed by validated questionnaires (The brief pain inventory & Back and Neck pain survey questionnaire). Visual analogue scale (score 0-10) is combined with questions about intensity and frequency of pain. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline fatigue and fatigability to 4 months | Validated questionnaires will be used to assess fatigue and fatigability (Mobility Fatigue, Mob-T, & The Pittsburgh Fatigability Scale). Scores ranging from 0-6 and 0-50, respectively. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline activities of daily living to 4 months | Activities of daily living will be assessed with self-report questionnaires. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline fear of falling to 4 months | Validated questionnaire will be used to assess fear of falling (the Falls Efficacy Scale - International). Score range from 16-64. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline Blood markers to 4 months | Analysis of changes in markers of health and disease will be performed, e.g. Lipid profile, Hormonal profile, protein-markers of inflammation (e.g. High Sensitive C-Reaktivt Protein (HS-CRP), soluble urokinase plasminogen activating receptor (suPAR)), vitamins and minerals. | Baseline and 4-months follow-up | |
Secondary | Chenages from baseline Objective measures of Physical activity, sedentary behaviour, nap and sleep to 4 months | Accelerometry methodology: level and patterns of physical activity (PA), sedentary behaviour (SB), nap and sleep (NAS) will be assessed with commercially available accelerometers (e.g. Axivity, Actigraph) placed on different anatomic locations (e.g. thigh, hip) for one week. | Baseline and 4-months follow-up | |
Secondary | Changes from baseline Self-reported Physical activity & sedentary behaviour to 4 months | Self-report questionnaire will be used to assess physical activity and sedentary behaviour (e.g. sedentary behaviour questionnaires). | Baseline and 4-months follow-up | |
Secondary | Changes from baseline Dietary intake to 4 month | Dietary intake is estimated by Four-day food records and food frequency questionnaires. Protein intake is calculated as average g/day and g/kg/day. | Baseline and 4-months follow-up | |
Secondary | 24 hours recall | Dietary intake is estimated from 24 hours recall. Protein intake is calculated as average g/day and g/kg/day. | pre phase 1 | |
Secondary | Changes from baseline Walking speed to 4 months | Self-selected and maximal walking speed is measured. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline Stand and reach to 4 months | The ability to stand and reach is tested | Baseline to 4 months follow-up | |
Secondary | Changes from baseline Walking distance to 4 months | The distance walked during 2- and 6-minutesis tested. | Baseline and 4 months follow-up | |
Secondary | Changes from baseline Upper body ball throwing to 4 months | The ability to throw a ball, using the upper body is tested. | Baseline to 4 months follow-up | |
Secondary | Changes from baseline Rising from laying position to 4 months | the ability to rise from laying position is tested. | Baseline to 4 months follow-up | |
Secondary | Changes from baseline Nutritional status to 4 months | Nutrititional status is estimated by validated questionnaires: the Mini Nutritional Assessment and Eating Validation Scheme. Scores range from 0-30 and 0-3, respectively. | Baseline and 4 months follow-up | |
Secondary | Changes in Risk of poor protein intake to 4 months | The questionnaire (protein screener) is used to estimate the probability score of having a low protein intake. | Baseline and 4 months |
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