Abstract
Nowadays, it is accepted that the regular practice of exercise and branched-chain amino acids supplementation (BCAAs) can benefit the immune responses in older persons, prevent the occurrence of physical frailty (PF), cognitive decline, and aging-related comorbidities. However, the impact of their combination (as non-pharmacological interventions) in albumin and the inflammatory markers is not fully understood. Therefore, we investigated the effect of a 40-week multifactorial intervention [MIP, multicomponent exercise (ME) associated or not with BCAAs] on plasma levels of inflammatory markers and albumin in frail older persons (≥75 years old) living at residential care homes (RCH). This study consisted of a prospective, naturalistic, controlled clinical trial with four arms of multifactorial and experimental (interventions-wahshout-interventions) design. The intervention groups were ME + BCAAs (n = 8), ME (n = 7), BCAAs (n = 7), and control group (n = 13). Lower limb muscle-strength, cognitive profile, and PF tests were concomitantly evaluated with plasma levels of albumin, anti- and pro-inflammatory cytokines [Interleukin-10 (IL-10) and Tumor Necrosis Factor-alpha (TNF-α) respectively], TNF-α/IL-10 ratio, and myeloperoxidase (MPO) activity at four different time-points: Baseline (T1), after 16 weeks of multifactorial intervention (T2), then after a subsequent 8 weeks washout period (T3) and finally, after an additional 16 weeks of multifactorial intervention (T4). Improvement of cognitive profile and muscle strength-related albumin levels, as well as reduction in the TNF-α levels were found particularly in ME plus BCAAs group. No significant variations were observed over time for TNF-α/IL-10 ratio or MPO activity. Overall, the study showed that MIP triggered slight alterations in the inflammatory and physical function of the frail older participants, which could provide independence and higher quality of life for this population.
Highlights
Aging is characterized as a natural degenerative process strongly linked to diminished immune efficiency, and to enhanced inflammatory responses, and to higher risks of infections in older persons [1]
Some studies have already shown that branched-chain amino acids supplementation (BCAAs) apparently increases albumin levels in older persons suffering from malnutrition [59]
Our results showed that the serum albumin levels were efficiently sustained or even augmented, in exercising participants during the first 16 weeks of intervention
Summary
Aging is characterized as a natural degenerative process strongly linked to diminished immune efficiency, and to enhanced inflammatory responses, and to higher risks of infections in older persons [1]. The sedentary lifestyle, per se, is one of the most important contributors to age-related illness, whereas regular physical exercises (rPE)—based on hormesis principles—could chronically slow down the aging immune/inflammatory dysfunctions [2]. In this sense, reduction of systemic levels of interleukin-10 (IL-10), a classical anti-inflammatory cytokine, with elevation on Tumor Necrosis Factor-alpha (TNF-α) levels are associated with aging [3]. In turn, is characterized by confusion and progressive loss of memory and neuromotor skills [10] These two outcomes reveal biological and phenotypic similarities, which is the reason leading to the current scientific interest in investigating populations affected by these disorders [11]. Recent findings have shown that multicomponent exercise (ME) interventions, those that include different types of endurance, muscle strength, and balance exercises in the same session, appear to have a superior effect on cognitively and physically frail older persons [14,15]
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