NUTRITIONAL ASSESSMENT AND DIETARY INTERVENTION TO PREVENT AND/OR SLOW DOWN THE DEVELOPMENT OF MALNUTRITION AND FRAILTY IN THE ELDERLY.

Background and aims: Sarcopenia and frailty syndrome negatively impact on health, with poor clinical outcomes, increased mortality. An adequate dietary strategy and regular physical activity can preserve strength and muscle function in older adults. This study aims to evaluate the effectiveness of a personalized energy-protein intake with cobalamine and pyridoxine dietary intake according to national and international nutrition guidelines, in reducing loss of muscle mass and frailty progression age-related. Methods: Elderly (≥65 years) with BMI (Body Mass Index) value of 20-30 kg/m2, free from uncontrolled chronic pathologies and physical-cognitive-neurological disabilities are recruited. The Mediterranean Diet intervention provides for 25-30 Kcal/kg/day and 1-1.2 g of protein/kg/day, with protein-dietary intake redistribution in daily meals in one of the two study arms (Group A). Data were expressed as mean±SD and percentages, analyzes were investigated by T-test and Pearson's coefficient (p<0,05). For each outpatient, sarcopenia screening (EWGSOP2), eating habits, autonomy in daily activities, cognitive status, physical activity, anthropometric and biopedenziometric measurements, handgrip strength and physical performance are collected. Outpatients are followed up with a reassessment of the same protocol every 3 months, for 12 months and biochemical tests every 6 months. Data were expressed as mean±SD and percentages, analyzes were investigated by T-test and Pearson’s coefficient (p<0.05). Results: 85 subjects aged 73±5 years were analyzed. At baseline 1 subject was sarcopenic, none were malnourished or frailty. We observed a reduction in waist circumference and fat mass with increased PhA and maintenance of lean mass, an improvement in handgrip strength and gait speed (p<0.05). Furthermore, PhA and gait speed were better in group A (p<0.05). Greater handgrip strength and faster gait speed were associated with protein intake at breakfast (r=0.266; p=0.0035, r=-0.348, p=0.005, respectively). We also record positive association between dietary B12 intake and handgrip strength (r=0.263; p<0.05) Conclusions: Adeguate weight and balanced dietary intervention redistributing protein intake to daily meals, with adeguate energy intake and sufficient vitamins B6 and B12 intake, could be useful to preserve skeletal muscle mass and function and indipendence in daily activities in the elderly.