A double-blind randomised controlled trial assessing the effect of menaquinone producing probiotics on vitamin K status.

Background: Inadequate dietary intake and malnutrition are commonly found in older adults. They tend to have early satiety that limits intake from main meals. Some reports indicated that small frequent meals may promote higher intake. From that point of view, snacks may be useful. Therefore, this study aimed to determine the effects of frequent snacks on energy intakes and nutritional status in older adults at risk of malnutrition. Methods: A randomized controlled study was conducted among older adults at risk of malnutrition in a suburban community from November 2020 to March 2021 in Chiang Mai, Thailand. Two villages were randomly assigned to either a control group (n=17) or an intervention group (n=17), and they were matched pairs by age and gender. An intervention snack consisted of 2 desserts and a box of milk (total 548 kcal) was used. For the first 3 weeks, an intervention snack was provided every day although it was too heavy for some participants. Therefore, after that, the intervention snack was provided every other day for 4 weeks. A nutrition survey by the 24-hour recall method for 3 days, body weight, mid-arm circumference (MAC), triceps skinfold (TSF), and grip strength were assessed at weeks 3 and 7 as baseline. Results: Thirty-one participants completed the study (91%). The average age was 71.8±4.8 years, and body mass index (BMI) was 19.0±2.1 kg/m2 . In the intervention snack group, there was an increased daily energy intake by 316 kcal and 214 kcal at weeks 3 and 7, respectively, (P<0.001, effect size: 0.884), with a body weight of 0.8 kg (P<0.001, effect size: 0.314), BMI of 2% (P=0.009, effect size: 0.314), and MAC of 4% (P<0.001, effect size: 0.265) compared with baseline, but such energy intake was not observed in the control group. Conclusion: Providing frequent snacks was an effective way to improve energy intake and nutritional status in community-dwelling older adults at risk of malnutrition.

Oral nutrition supplements (ONSs) play an important role in the management of malnutrition. This aim of study was to examine whether a comprehensive intervention, combining ONSs, family-centered health education, and nutrition and medical consultations, could improve the nutrition and health status of malnourished older adults living in community dwellings. A randomized controlled trial was conducted from October 2017 to May 2018 in Shanghai. All participants were screened using the Mini Nutritional Assessment-Short Form (MNA-SF). Participants with MNA-SF scores ≤11 and age ≥65 were selected. Participants with potential nutrition risk were randomized into two groups: intervention group (n = 101) were prescribed ONSs (400 kcal/day) and family-centered nutrition education (once every 2 weeks) and control group (n = 100) received only family-centered nutrition education. Anthropometric measurements, including weight and height, and nutrition and functional scales, including MNA-SF, grip strength, and activities of daily living scores, were collected at the beginning of the study and 12 weeks later. Of the 201 study participants, 182 completed the study (mean age, 75.48 ± 7.47 years). After 12 weeks, nutrient intake improvements in the intervention group (+370.6 ± 432.6 kcal/day, +17.6 ± 24.1 g/day) exceeded that of the control group (-67.5 ± 378.2 kcal/day, -0.9 ± 16.7 g/day). In addition, improvements in weight, body mass index, and handgrip strength were significantly higher in the intervention vs control group (P < .05). Comprehensive nutrition interventions improved nutrition status in malnourished older people living in community dwellings. Use of ONSs may be a good strategy to improve nutrition status and strength in community-dwelling older adults.

Frailty and malnutrition have emerged as critical public health issues amidst global population aging. Malnutrition not only significantly contributes to frailty but also intensifies its clinical symptoms, severely affecting the quality of life and health outcomes in older adults. Research in this field has accelerated in recent years; however, a comprehensive analysis of key research trends and hotspots remains absent. This study employs bibliometric methods to systematically analyze core themes and emerging research directions related to nutritional status and frailty in older adults, identifying potential research frontiers and guiding future development. A comprehensive search was conducted in the Web of Science Core Collection (WoSCC) database on November 6, 2024, using keywords relevant to frailty and nutrition status in older adults. Bibliometric analyses and knowledge mapping were performed using CiteSpace, VOSviewer, and R software. Between 2005 and 2024, 2,357 publications on frailty and nutrition status in older adults were produced by 13,080 researchers from 3,987 institutions across 88 countries. The volume of publications has shown a consistent upward trajectory over the past two decades (R2 = 0.84), with projections indicating a continued increase, peaking at 315 publications by 2033. This sustained growth underscores the field's significance and ongoing research interest. Early research has centered on the "home-living elderly" demographic, while current investigations have shifted focus from molecular biology, genetics, and health nursing to more clinical and medical domains. Key areas of emphasis now include nutrition and dietetics, geriatrics, oncology, and pharmacology. Emerging research hotspots involve the early identification and management of malnutrition to reduce frailty-related health risks and improve health outcomes and quality of life for older adults. Notable trends include the keywords "prediction," "nutritional assessment MNA," "intervention," and "infection." This bibliometric analysis offers a comprehensive examination of the research evolution, hotspots, and emerging frontiers in frailty and nutrition status among older adults over the past two decades. The findings provide an objective overview of the academic landscape, offering valuable insights for future research, resource allocation, and policymaking.

Risk of sarcopenia and poor nutritional status are observed in older adults receiving home care. Hence, the aim of the POWER trial is to investigate the effectiveness of a whey protein oral nutritional supplement (ONS) combined with an online resistance training (RT) programme compared to RT alone on physical function, nutritional status and health-related outcomes in community-dwelling older adults receiving supportive home care who are at risk of sarcopenia. This home-based, randomised controlled trial will include older adults aged ≥70 years, receiving supportive home care (professional and/or informal), who will be screened for sarcopenia via telephone. Forty-six participants will be randomised into either (i) ONS + RT or (ii) RT only trial arms. Participants in the ONS + RT group will be provided with a whey protein ONS enriched with leucine and vitamin D to consume day daily for 12 weeks. All participants will be provided with an online RT programme twice weekly via Zoom. The primary outcomes are physical function, measured using the Timed Up and Go test and nutritional status, measured using the Mini-Nutritional Assessment-Full Form. Secondary outcomes include body composition, dietary intake, gait speed, muscle strength, cognitive function, depression risk, activities of daily living, quality of life and feasibility of intervention implementation. All outcomes will be measured at baseline (T1), post-intervention (T2) and 12 weeks post-intervention (T3). This study will provide data on the effectiveness of a whey protein ONS enriched with leucine and vitamin D combined with an online RT programme delivered via Zoom, compared to the RT programme alone, for older adults at risk of sarcopenia and receiving supportive home care. If effective, this combined approach could act as an important strategy to support maintenance of physical function and nutritional status in older adults, for whom home-based interventions are likely a more feasible option. NCT05688956; registered December 2022.

Background Risk of sarcopenia and poor nutritional status are observed in older adults receiving home care. Hence, the aim of the POWER trial is to investigate the effectiveness of a whey protein oral nutritional supplement (ONS) combined with an online resistance training (RT) programme compared to RT alone on physical function, nutritional status and health-related outcomes in community-dwelling older adults receiving supportive home care who are at risk of sarcopenia. Methods This home-based, randomised controlled trial will include older adults aged ≥70 years, receiving supportive home care (professional and/or informal), who will be screened for sarcopenia via telephone. Forty-six participants will be randomised into either (i) ONS + RT or (ii) RT only trial arms. Participants in the ONS + RT group will be provided with a whey protein ONS enriched with leucine and vitamin D to consume day daily for 12 weeks. All participants will be provided with an online RT programme twice weekly via Zoom. The primary outcomes are physical function, measured using the Timed Up and Go test and nutritional status, measured using the Mini-Nutritional Assessment-Full Form. Secondary outcomes include body composition, dietary intake, gait speed, muscle strength, cognitive function, depression risk, activities of daily living, quality of life and feasibility of intervention implementation. All outcomes will be measured at baseline (T1), post-intervention (T2) and 12 weeks post-intervention (T3). Conclusion This study will provide data on the effectiveness of a whey protein ONS enriched with leucine and vitamin D combined with an online RT programme delivered via Zoom, compared to the RT programme alone, for older adults at risk of sarcopenia and receiving supportive home care. If effective, this combined approach could act as an important strategy to support maintenance of physical function and nutritional status in older adults, for whom home-based interventions are likely a more feasible option. Trial registration NCT05688956 ; registered December 2022.

BackgroundRisk of sarcopenia and poor nutritional status are observed in older adults receiving home care. Hence, the aim of the POWER trial is to investigate the effectiveness of a whey protein oral nutritional supplement (ONS) combined with an online resistance training (RT) programme compared to RT alone on physical function, nutritional status and health-related outcomes in community-dwelling older adults receiving supportive home care who are at risk of sarcopenia.MethodsThis home-based, randomised controlled trial will include older adults aged ≥70 years, receiving supportive home care (professional and/or informal), who will be screened for sarcopenia via telephone. Forty-six participants will be randomised into either (i) ONS + RT or (ii) RT only trial arms. Participants in the ONS + RT group will be provided with a whey protein ONS enriched with leucine and vitamin D to consume day daily for 12 weeks. All participants will be provided with an online RT programme twice weekly via Zoom. The primary outcomes are physical function, measured using the Timed Up and Go test and nutritional status, measured using the Mini-Nutritional Assessment-Full Form. Secondary outcomes include body composition, dietary intake, gait speed, muscle strength, cognitive function, depression risk, activities of daily living, quality of life and feasibility of intervention implementation. All outcomes will be measured at baseline (T1), post-intervention (T2) and 12 weeks post-intervention (T3).ConclusionThis study will provide data on the effectiveness of a whey protein ONS enriched with leucine and vitamin D combined with an online RT programme delivered via Zoom, compared to the RT programme alone, for older adults at risk of sarcopenia and receiving supportive home care. If effective, this combined approach could act as an important strategy to support maintenance of physical function and nutritional status in older adults, for whom home-based interventions are likely a more feasible option.Trial registrationNCT05688956; registered December 2022.

BackgroundFrailty in older adults is a common aging-related syndrome that can lead to adverse health outcomes. Although physical exercise and nutritional interventions have been widely recognized as beneficial for managing frailty, the comparative effectiveness of various intervention approaches remains uncertain.ObjectiveWe systematically evaluated the effects of multicomponent exercise, nutritional supplementation, and combined interventions on frailty status and functional outcomes in older adults using network meta-analysis.MethodsRandomized controlled trials (RCTs) published between 2006 and 2025 were searched to include studies assessing the effects of multicomponent exercise, nutritional supplements (including amino acids and proteins, etc.), combined interventions, or standard care on frailty status in older adults aged ≥ 60 years. Changes in frailty scores constituted the primary outcome. Secondary outcomes comprised gait speed, the Short Physical Performance Battery (SPPB), and the Timed Up-and-Go test (TUG). Effect sizes were calculated using Standardized Mean Difference (SMD) and 95% Confidence Interval (CI), and ranked using network meta-analysis.ResultsUltimately, 22 RCTs involving 2,055 participants were included, with comparable baseline characteristics among participants. Regarding the improvement in frailty scores, combined interventions demonstrated the greatest improvement (SMD = -0.92, 95% CI: -1.43 to -0.40), followed by multicomponent exercise (SMD = -0.78, 95% CI: -1.15 to -0.43), while nutritional supplementation showed a trend toward improvement that did not reach statistical significance (SMD = -0.69, 95% CI: -1.67 to 0.27). For gait speed, nutritional supplementation (SMD = + 0.37, 95% CI: +0.06 to + 0.68) yielded the greatest improvement, while multicomponent exercise (SMD = + 0.09, 95% CI: -0.04 to + 0.22) showed minimal benefit. Significant improvement in SPPB scores was observed only after multicomponent exercise (SMD = + 1.85, 95% CI: +0.33 to + 3.50). In the TUG test, combined interventions (SMD = -4.61, 95% CI: -9.36 to + 0.25) tended to reduce completion time (non-significant); conversely, multicomponent exercise alone significantly increased time (SMD = + 3.96 s, 95% CI: +0.91 to + 7.07). Low heterogeneity was observed across outcomes with no evidence of publication bias.ConclusionThe impacts of different interventions on frailty in older adults exhibited outcome-specific variations. Combined interventions were most effective in improving frailty scores, demonstrating potential synergistic effects between physical exercise and nutrition, while nutritional supplementation showed the most significant benefit for gait speed. Multicomponent exercise alone also produced significant improvements in frailty scores and physical performance. These findings suggest that clinicians should consider combined approaches for overall frailty improvement while tailoring interventions based on specific functional objectives when developing management strategies for frailty in older adults.Trial registrationCRD420251038055.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-026-07111-8.

A two-year longitudinal study of the impact of cognitive status and depression on frailty status in older adults following hip fracture.

Objective We aimed to investigate the association between gait speed and cognitive status in outpatient older adults from a resource-limited setting in Peru. Methods We performed a cross-sectional study including older adults aged ≥60 years attending a geriatrics outpatient clinic between July 2017 and February 2020. Gait speed was measured over a 10-meters distance without considering the first and last meter traveled. Cognitive status was assessed through the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). We used a multivariate binomial logistic regression to conduct both an epidemiological and fully adjusted models. Results We included 519 older adults (mean age: 75 years; IQR = 10), of whom 95 (18.3%) and 151 (31.5%) were cognitively impaired according to the SPMSQ and MMSE, respectively. Gait speed was slower among patients with poorer cognitive status as assessed by both tools (p < 0.001). Malnutrition (PR: 1.74; CI: 1.45–2.08) and functional dependency (PR: 4.35; CI: 2.68–7.08) were associated with a greater prevalence of cognitive impairment according to the SPMSQ, whereas a faster gait speed (PR: 0.27, CI: 0.14–0.52) and longer years of education (PR: 0.83, CI: 0.77–0.88) were associated with a less prevalence. Conclusions Slower gait speed was associated with poorer cognitive status in outpatient older adults. Gait speed may be a complementary tool in the cognitive assessment of older adults from resource-limited settings.

Dietary protein and beef consumption predict for markers of muscle mass and nutrition status in older adults.

BackgroundAs the only optically accessible part of the central nervous system, the retina represents an intriguing opportunity for the detection of biomarkers for Alzheimer’s disease (AD). This study evaluated the performance of the Retinal Deep PhenotypingTM platform, a digital biomarker platform comprising a hyperspectral retinal camera and image analysis algorithms, for the detection of likely positron‐emission tomography (PET) amyloid status (negative or positive) in older adults. A set of phenotypic features that correlates with the cerebral amyloid status as determined by amyloid PET scan were identified and used to train a classifying algorithm.MethodHyperspectral retinal images acquired with a Mydriatic Hyperspectral Retinal Camera from 194 participants (age ≥ 50 years), including cognitively normal and cognitively impaired (mild cognitive impairment and dementia) across 5 imaging sites were processed in order to train the model. Of these 194 participants, 73 individuals (38%) were amyloid‐positive, as confirmed by unanimous readings of PET scans by a panel of 3 expert reviewers. The pre‐processed hyperspectral images were segmented into various anatomical sites, and a texture‐based approach was used to extract several thousands of spatial‐spectral features. The most relevant features for the classification task were selected using a minimum redundancy maximum relevance (MRMR) algorithm and used to train a linear support vector machine (SVM) classifier. A nested, cross‐validation technique was used to evaluate the performance of the classifier.ResultThe resulting model based on the 17 most significant features showed high performance to discriminate between amyloid positive and negative subjects with an area under the receiver operating curve (AUCROC) of 0.87 (95% CI: 0.83 – 0.92).ConclusionThe Retinal Deep PhenotypingTM platform shows promise for detecting the likely cerebral amyloid PET status in adults 50 years and older from a simple, non‐invasive retinal scan and could provide an accessible means to identify individuals with abnormal cerebral amyloid in a clinical or drug development context. This phenotyping platform provides a flexible approach that could also be used for the detection of multiple biomarkers involved in cognitive decline from the same hyperspectral images of the retina.

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Polypharmacy regimens may increase the susceptibility of older adults to micronutrient inadequacy and deficiency via impairment of nutritional status. We hypothesized that a multi-vitamin-mineral supplement (MVMS) could improve nutritional status in older adults prescribed diuretics, metformin, and/or proton pump inhibitors (PPIs). We conducted a randomized, double-blind, placebo controlled, parallel clinical trial in which eligible subjects were instructed to consume either a MVMS or placebo for 16 wk. Fasting blood was collected at baseline, 8, and 16 wk and the status of selected vitamins and minerals determined. Thirty-five and 19 men and women aged 45–75 yrs in the in MVMS and placebo arms, respectively, completed the trial. The mean total number of medications among the three drug classes taken by participants did not differ between two groups. The status of vitamins B1, B12, C and folate and calcium, copper, magnesium and zinc at baseline were within normal ranges. The MVMS group had a greater change in nutrient status after 16 wk compared to the placebo group for serum folate (7.5 vs. –1.6 ng/mL, p < 0.0001), vitamin B12 (159.2 vs. –33.9 pg/mL, p = 0.007), and plasma vitamin C (0.2 vs. 0.0 mg/dL, p = 0.004). Other measured vitamins and minerals were not significantly changed during the intervention. In conclusion, the status of vitamins B12, C and folate improved with MVMS but remained within normal ranges in older adults taking diuretics, metformin, and/or PPIs.

Associations Between Dentition Status and Nutritional Status in Community-Dwelling Older Adults

Effects of multicomponent exercise on frailty status and physical function in frail older adults: A meta-analysis and systematic review