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Title: Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: VIVE2 randomized controlled trial

Author
item VON BERENS, ASA - Uppsala University
item FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item GUSTAFSSON, THOMAS - Karolinska Institute
item KIRN, DYLAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item LAUSSEN, JONATHAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item NYDAHL, MARGARETHA - Uppsala University
item REID, KIERAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item TRAVISON, THOMAS - Hebrew Senior Life
item ZHU, HAO - Hebrew Senior Life
item CEDERHOLM, TOMMY - Uppsala University
item KOOCHEK, AFSANEH - Uppsala University

Submitted to: BMC Geriatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/6/2018
Publication Date: 11/21/2018
Citation: Von Berens, A., Fielding, R.A., Gustafsson, T., Kirn, D., Laussen, J., Nydahl, M., Reid, K.F., Travison, T.G., Zhu, H., Cederholm, T., Koochek, A. 2018. Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: VIVE2 randomized controlled trial. BMC Geriatrics. 18:286. https://doi.org/10.1186/s12877-018-0976-z.
DOI: https://doi.org/10.1186/s12877-018-0976-z

Interpretive Summary: Health-related quality of life (HRQoL) and a reduction in depressive symptoms are of great importance for older people and may be achieved through lifestyle interventions such as exercise or nutrition. The aim of this investigation was to analyze the effects of a physical activity program in combination with a protein supplement on HRQoL and depressive symptoms in community dwelling older adults. We used data from the Vitality, Independence, and Vigor 2 Study (VIVE2), community dwelling men and women with an average age of 77.5 years, some mobility limitations and low serum vitamin D levels from two study sites (Stockholm, Sweden and Boston, USA) who were assigned to receive a nutritional supplement or a placebo for six months. All subjects received a physical activity program 2-3 times per week. We observed a significant improvement in both Mental Component Summary and The Centre for Epidemiologic Studies Depression Scale during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in Physical Component Summary. This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.

Technical Abstract: Background: Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community dwelling, mobility limited older adults. Methods: In the Vitality, Independence, and Vigor 2 Study (VIVE2), community dwelling men and women with an average age of 77.5+/-5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5-60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for six months. All took part in a physical activity program 2-3 times/ week. The primary outcome examined in VIVE2 was 400M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed). Results: For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (-4.5, -0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories. Conclusions: This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.