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. 2017;2(2):137.
doi: 10.4172/2573-0312.1000137. Epub 2017 Apr 24.

Feasibility of Conducting a 6-month long Home-based Exercise Program with Protein Supplementation in Elderly Community-dwelling Individuals with Heart Failure

Masil George  1 , Gohar Azhar  1 , Amanda Pangle  1 , Eric Peeler  1 , Amanda Dawson  1 , Robert Coker  1 , Kellie S Coleman  1 , Amy Schrader  1 , Jeanne Wei  1
Affiliations

Feasibility of Conducting a 6-month long Home-based Exercise Program with Protein Supplementation in Elderly Community-dwelling Individuals with Heart Failure

Masil George et al. J Physiother Phys Rehabil. 2017.

Abstract

Objective: Cardiac cachexia is a condition associated with heart failure, particularly in the elderly, and is characterized by loss of muscle mass with or without the loss of fat mass. Approximately 15% of elderly heart failure patients will eventually develop cardiac cachexia; such a diagnosis is closely associated with high morbidity and increased mortality. While the mechanism(s) involved in the progression of cardiac cachexia is incompletely established, certain factors appear to be contributory. Dietary deficiencies, impaired bowel perfusion, and metabolic dysfunction all contribute to reduced muscle mass, increased muscle wasting, increased protein degradation, and reduced protein synthesis. Thus slowing or preventing the progression of cardiac cachexia relies heavily on dietary and exercise-based interventions in addition to standard heart failure treatments and medications.

Methods: The aim of the present study was to test the feasibility of an at-home exercise and nutrition intervention program in a population of elderly with heart failure, in an effort to determine whether dietary protein supplementation and increased physical activity may slow the progression, or prevent the onset, of cardiac cachexia. Frail elderly patients over the age of 55 with symptoms of heart failure from UAMS were enrolled in one of two groups, intervention or control. To assess the effect of protein supplementation and exercise on the development of cardiac cachexia, data on various measures of muscle quality, cardiovascular health, mental status, and quality of life were collected and analyzed from the two groups at the beginning and end of the study period.

Results: More than 50% of those who were initially enrolled actually completed the 6-month study. While both groups showed some improvement in their study measures, the protein and exercise group showed a greater tendency to improve than the control group by the end of the six months.

Conclusion: These findings suggest that with a larger cohort, this intervention may show significant positive effects for elderly patients who are at risk of developing cardiac cachexia.

Keywords: Exercise; aging; cardiac cachexia; heart failure; physical function; protein supplementation; weakness.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Schematic illustrating the progression of heart failure to cardiac cachexia. Heart failure induces a state of systemic inflammation, inciting dysregulation and imbalances in the gastrointestinal and neuroendocrine systems. This leads to progressive muscle degradation both in terms of muscle quantity and muscle quality.
Figure 2
Figure 2
Flow diagram of study design and subject enrollment. UAMS patients 55 years and older with heart failure were invited to participate in this study.
See this image and copyright information in PMC

References

    1. Azhar G, Wei JY. The Demographics of Aging and Its Impact on the Cardiovascular Health. Current Cardiovascular Risk Reports. 2015;9(4):1–6.
    1. Brownie S. Why are elderly individuals at risk of nutritional deficiency? International journal of nursing practice. 2006;12(2):110–118. doi: 10.1111/j.1440-172X.2006.00557.x. - DOI - PubMed
    1. Jiang J, Sachdev P, Lipnicki DM, Zhang H, Liu T, et al. A longitudinal study of brain atrophy over two years in community-dwelling older individuals. Neuroimage. 2014;86:203–211. doi: 10.1016/j.neuroimage.2013.08.022. - DOI - PubMed
    1. Manini TM, Hong SL, Clark BC. Aging and muscle: a neuron's perspective. Current opinion in clinical nutrition and metabolic care. 2013;16(1) doi: 10.1097/MCO.0b013e32835b5880. - DOI - PMC - PubMed
    1. Azhar G, Raza S, Abid SA, Pangle AK, Schrader AM. Congestive Heart Failure Awareness Assessment in a Geriatrics Out-patient Clinic in Central Arkansas. J Res Development. 2015;3(128):2.

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