Nutritional intervention and functional exercises improve depression, loneliness and quality of life in elderly women with sarcopenia: a randomized clinical trial

Improvements to mood, stress and loneliness following 12-week multivitamin supplementation in older adults: a randomised, placebo-controlled, trial

BACKGROUND

Research has indicated the potential for multivitamin-mineral (MVM) supplementation to improve aspects of wellbeing and cognitive function in older adults via a range of biological mechanisms. However, outside of cognitive function and mood, this research rarely assesses other outcomes that are pertinent to the daily lives of older adults. The current study aimed to investigate the effectiveness of a MVM supplement on meaningful outcomes of everyday functioning in older adults.

METHODS

This randomised, double-blind, placebo-controlled, parallel groups trial investigated the effects of 12-week MVM supplementation on measures of wellbeing, mood, and memory; physical health and activity; and social interaction and loneliness. Outcomes were measured at baseline and after 12 weeks in a sample of 228 (124 female) older adults ( > 70 years).

RESULTS

MVM supplementation had no effect on the primary outcome of wellbeing (p = 0.29 in males, p = 0.421 in females), but led to increased feelings of friendliness in females (p = 0.045). In males, following MVM, there were lower levels of prolonged stress reactivity (p = 0.007), lower overall stress reactivity (p = 0.019), and lower emotional loneliness (p = 0.042).

CONCLUSION

This study provides novel evidence of increased friendliness and decreased stress reactivity and loneliness following MVM supplementation in older adults. These findings support the exploration of broader functions pertinent to aspects of daily living in older adults. Sex differences in response highlight the importance of exploring effects in men and women separately and support a recommendation for the inclusion of diverse samples in future research that are representative of the population.

Effects of exercise on depression and anxiety in postmenopausal women: a pairwise and network meta-analysis of randomized controlled trials

BACKGROUND

Exercise has been identified as a promising non-pharmacological therapy for the management of depression, but there is still controversy over which type is most effective. We aimed to compare and rank the types of exercise that improve depression in postmenopausal women by quantifying information from randomized controlled trials (RCTs).

METHODS

The PubMed, Web of Science, SPORTDiscus, CNKI, The Cochrane Library, PsycINFO, EMBASE, and CINAHL Plus databases were searched to identify articles published from inception to 1 March 2024 reporting RCTs that examined the effectiveness of exercise on depression in postmenopausal women. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for RCTs. The quality of the evidence for each comparison was graded using the online confidence in network meta-analysis tool (CINeMA). Standardized mean differences (SMDs) were calculated using the mean and standard deviation of pre-to-post intervention changes and then pooled using a random effects model in a pairwise meta-analysis using Review Manager 5.4. Then, a frequentist network meta-analysis was conducted using a random effects model was conducted to evaluate the efficacy of different exercise types using the network package of Stata 15.

RESULTS

This study included 26 studies involving 2,170 participants. The pairwise meta-analysis revealed that exercise had a significant positive effect on depression in postmenopausal women (SMD = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; I2 = 78%). The network meta-analysis revealed that mind-body exercise (SMD = -0.97, 95% CI = -1.28 to -0.67), aerobic exercise (SMD = -0.58, 95% CI = -0.88 to -0.27) and multicomponent exercise (SMD = -0.57, 95% CI = -1.15 to -0.002) significantly reduced depression compared to the control intervention. Mind-body exercise had the highest probability of being the most effective intervention. Exercise interventions also showed positive effects on anxiety. Most studies were judged to have some concerns regarding their risk of bias, and the confidence in evidence was often very low according to CINeMA.

CONCLUSION

For postmenopausal women, there is very low to moderate quality evidence that exercise interventions are an effective antidepressant therapy, with mind-body exercise most likely being the optimal type.

TRIAL REGISTRATION

This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42024505425).

The lived experiences of loneliness of older adults with chronic conditions aging at home: A qualitative systematic review and meta-aggregation

OBJECTIVE

To synthesize the best available evidence in exploring the experiences and perceptions of loneliness among older adults with chronic conditions aging at home.

METHODS

Web of Science, PubMed, Embase, CINAHL and other databases were searched, and qualitative research on the loneliness experience of older adults with chronic conditions aging at home was collected. The included studies were appraised independently by two reviewers using The JBI Critical Appraisal Checklist for Qualitative Research.

RESULTS

6 studies were included and 4 themes were summarized, including: (a) negative emotions and unmet social needs of loneliness, (b) self-perceived influences of chronic conditions on loneliness, (c) self-strategy to deal with loneliness, and (d) social support to alleviate loneliness.

CONCLUSION

Older adults aging at home were suffering from negative emotions and unmet social needs of loneliness, which were influenced by their chronic conditions, and they adopted self-strategies and social supports to cope with their loneliness.

Health maintenance through home-based interventions for community-dwelling older people with sarcopenia during and after the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic has greatly impacted people's lifestyles and changed the delivery of health interventions, especially interventions for community-dwelling older people with sarcopenia.

OBJECTIVE

To summarize the components and explore the effectiveness of home-based interventions for improving sarcopenia and other health-related outcomes among community-dwelling older people with sarcopenia.

DESIGN

Systematic review and meta-analysis.

METHODS

The Cochrane Library, Scopus, EMBASE, Web of Science, CINAHL, Medline (via PubMed), and PsycINFO were searched for relevant papers published from January 1, 2010 to March 29, 2022. Only papers written in English were included. The modified version of Cochrane's risk-of-bias tool was used to assess the risks of bias in the included studies. The template for intervention description and replication checklist was used to summarize the intervention components. The mean difference (MD) or standard mean difference with a 95 % confidence interval (CI) was used to determine the effect size of studies using the same or different measuring methods. Random-effects models were in meta-analyses to pool the effects of home-based interventions on the included outcomes.

RESULTS

After detailed screening and exclusion, 11 randomized controlled trials including 1136 older people with sarcopenia were included in our analyses. Three categories of home-based interventions were identified: exercise interventions, nutritional interventions, and combined exercise and nutritional interventions. The overall analysis of the outcomes (e.g., appendicular skeletal muscle mass index, lean mass, body fat mass, handgrip strength, and gait speed), showed that the effects of home-based exercise interventions were inconclusive. Compared with passive controls, home-based exercise interventions significantly improved knee extension strength (MD = 0.56 kg, 95 % CI: 0.09, 1.03, p = 0.020) and reduced the time required to complete the Timed Up and Go Test (MD = -1.41 s, 95 % CI: -2.28, -0.54, p = 0.001). Home-based nutritional interventions were effective in improving appendicular skeletal muscle mass (MD = 0.25 kg, 95 % CI: 0.02, 0.49, p = 0.030), gait speed (MD = 0.06 m/s, 95 % CI: 0.03, 0.09, p = 0.0001), and quality of life in terms of both the physical component summary (MD = 13.54, 95 % CI: 0.73, 26.34, p = 0.040) and mental component summary scores (MD = 8.69, 95 % CI: 2.98, 14.41, p = 0.003).

CONCLUSION

Home-based exercise interventions have the potential to improve muscle strength and physical function, while home-based nutritional interventions are effective in increasing muscle mass, physical function, and quality of life. Both of these can be applied at home during and after the COVID-19 pandemic to alleviate sarcopenia and improve health-related outcomes in community-dwelling older people.

Possible Sarcopenia and Its Association with Nutritional Status, Dietary Intakes, Physical Activity and Health-Related Quality of Life among Older Stroke Survivors

Background

Screening for sarcopenia in the stroke population is an emerging concept in research and clinical practice. Therefore, this cross-sectional study aimed to assess the prevalence of possible sarcopenia and its associated factors among older stroke survivors who visited the neurology and rehabilitation departments of three public hospitals in Malaysia.

Methods

We acquired data on sociodemographic characteristics, clinical profiles, malnutrition risk, dietary intake, physical activity level, and health-related quality of life. Possible sarcopenia was diagnosed in individuals with decreased calf circumference and low handgrip strength, as proposed by the Asia Working Group for Sarcopenia (2019). Finally, we performed descriptive analysis and binary logistic regression.

Results

Among 196 older adults with stroke (mean± standard deviation of age: 67.60 ± 5.70 years), 42.3% had possible sarcopenia, with a higher prevalence in the more advanced age group (≥70 years). In univariable analysis, possible sarcopenia was significantly associated with anthropometric indices, malnutrition risk, nutrient intake, physical activity level, and health-related quality of life. In multivariable analysis, body mass index (adjusted odds ratio [AOR]=0.57; 95% confidence interval [CI], 0.43–0.75) was the only factor associated with possible sarcopenia among individuals aged ≥70 years. Recurrent stroke (AOR=3.48; 95% CI, 1.02–11.92), body mass index (AOR=0.64; 95% CI, 0.54–0.76), and EQ-5D index (AOR=0.15; 95% CI, 0.03–0.78) were significantly associated with possible sarcopenia in the 60–69-year age group.

Conclusion

The prevalence of possible sarcopenia among community-dwelling older stroke survivors was high. Therefore, we recommend routine screening for possible sarcopenia to ensure early nutritional and exercise intervention.

Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults

Background: Little is known about the relationships between muscle strength and nutritional health risk with late-in-life depression. This study aimed to investigate the moderating effect of lower-extremity muscle strength on the relationship between nutritional health risk and depression in Korean older adults. Methods: Data obtained from 5949 women and 3971 men aged ≥ 65 years in the 2020 Korea Longitudinal Study on Aging were used in this study. Exposures included lower-extremity muscle strength and nutritional health risk. Lower-extremity muscle strength was measured with a modified sit-to-stand test. The nutritional health risk was assessed using a screening tool. Depression was defined as a score ≥ 8 points on the Geriatric Depression Scale (GDS). Results: Logistic regression analyses showed that depression was positively associated with nutritional health risk (p < 0.001) and inversely associated with lower-extremity muscle strength (p < 0.001). A moderation analysis with Andrew Hayes’ PROCESS macro showed a significant moderating effect of lower-extremity muscle strength (β = −0.119; 95% confidence interval, −0.172 to −0.066; p < 0.001) on the relationship between nutritional health risk and depression; the weaker was the muscle strength, the steeper was the slope of the GDS score for nutritional health risk. Conclusions: The current findings suggest the need for an intervention targeting both high nutritional risk and weak muscle strength as a therapeutic strategy against depression in Korean older adults.

Yoga implications for preventing accidental falls in older adults: a systematic review

Abstract Introduction: Studies have shown the importance of healthy habits in older adults, emphasizing physical activity or mobility for a better quality of life and to delay physical degeneration in this population. Yoga is one of several exercises recommended for therapeutic purposes to reduce the risk of falls, a common occurrence in this age group. Objective: To synthesize the existing evidence regarding the effects of yoga on quality of life and physical-functional capacity and its contribution to fall prevention in older people. Methods: This systematic review was conducted in August 2020 on the Medline/Pubmed, LILACS, SCOPUS, Web of Science and PEDro databases, with no restrictions for language or year of publication. In line with the eligibility criteria, randomized or quasi-randomized clinical trials were included. Results: A total of 1,190 articles were found, 18 of which were included for data collection. The average sample size was between 16 and 120 participants, consisting of older individuals of both sexes ranging in age from 62 to 85 years. Conclusion: Regular yoga practice has a beneficial effect on the quality of life and physical-functional capacity of older adults, thereby contributing to fall prevention. However, evidence is still limited and further studies are suggested to better elucidate the scope of the effects of yoga as a therapeutic resource.

Functional capacity, risk of falling and chronic pain in older adults during the COVID-19 pandemic: a telemonitoring study

OBJECTIVE: To compare active and sedentary older adults regarding functional capacity, risk of falling, and chronic pain in a population assisted by telemonitoring during the pandemic lockdown. METHODS: This analytical, cross-sectional study included 104 older adults who were telemonitored during the COVID-19 lockdown by a team from a Brazilian Unified Health System outpatient clinic specializing in geriatrics and gerontology. A structured interview was used to collect data. Following normality testing with the Shapiro-Wilk test, Student’s t-test was used for group comparisons. Associations were analyzed using the χ2 test, and the odds ratio was calculated in a 2x2 table of sedentarism and falls in the last six months. The data were analyzed using SPSS version 26.0, with p ≤ 0.05 considered significant. RESULTS: The 57 active older adults had a lower rate of continuous medication use (24.84 vs 27.62%), fewer falls (50 vs 32.11%), less pain (12.31 vs 3.83%), and greater independence in basic activities of daily living (44.39 vs 26.46%). CONCLUSIONS: Older adults who were physically active in the midst of social distancing had better functional capacity in basic activities of daily living, fewer falls, and less pain than their sedentary peers. Independence in instrumental activities of daily living did not differ significantly between the groups.