RESUMEN
BACKGROUND: The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. METHODS: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. RESULTS: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. CONCLUSION: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
Asunto(s)
Fragilidad , Sarcopenia , Anciano , Ejercicio Físico , Estudios de Factibilidad , Humanos , Vida Independiente , Sarcopenia/epidemiologíaRESUMEN
BACKGROUND: The monitoring of the late effects of childhood cancer treatments was established approximately in the 1970s. With an increasing number of children cancer survivors the identification of the short-term or late effects becomes more detailed. The psychosocial and cognitive problems are of the most frequent sequelae of the cancer treatment and their prevalence is nearly 20% in survivors of childhood cancer. These problems can have an adverse impact on further professional career or private life in the childhood cancer survivors. The most threatened group of patients are children treated for brain tumors and acute lymphoblastic leukemia. DESIGN: The object of this paper is to review the present information in the area of the neuropsychological sequelae in the childhood cancer survivors. CONCLUSIONS: Identification of the specific cognitive problems in childhood cancer survivors can have the profound impact on improvement of the support delivered to the children and adolescents by their families, in the school and further career. Tailored interventions can have the positive impact on the quality of life of this subgroup of children. Multidisciplinary approach including routine psychological screening is necessary for addressed follow-up care concerning this vulnerable at-risk population.
