Reinforcement Effects of Social Network Intervention during Nutritional Supplementation in Frail Older Adults

Chang-O Kim; Yunhui Jeong; Younjin Park; Jeong-Sook Bae; Yoonjeong Kwon; Mihee Cho; Chang Hee Yoo; Kyung-Eun Lee

doi:10.1159/000514676

Reinforcement Effects of Social Network Intervention during Nutritional Supplementation in Frail Older Adults

Gerontology. 2021;67(5):620-632. doi: 10.1159/000514676. Epub 2021 May 11.

Authors

Chang-O Kim^{1

2}, Yunhui Jeong³, Younjin Park⁴, Jeong-Sook Bae⁵, Yoonjeong Kwon², Mihee Cho^{1

2}, Chang Hee Yoo⁵, Kyung-Eun Lee⁵

Affiliations

¹ Visiting Doctors Program of Medical Home, Seoul, Republic of Korea.
² Institute of Social Welfare, Sungkonghoe University, Seoul, Republic of Korea.
³ Department of Human Ecology, Food, and Nutrition, Korea National Open University, Seoul, Republic of Korea.
⁴ Department of Social Welfare, Catholic University of Korea, Seoul, Republic of Korea.
⁵ Department of Food and Nutrition, Seoul Women's University, Seoul, Republic of Korea.

PMID: 33975304
DOI: 10.1159/000514676

Abstract

Introduction: Chronic undernutrition and a homebound state are corelated and are both important components of frailty. However, whether social network intervention combined with protein supplementation is an effective strategy to prevent functional decline among frail older adults is unclear.

Methods: 150 frail older adults participated in a 3-month, 3-armed, community-based clinical trial and were randomly assigned to one of 3 groups: high-protein supplementation (additional 27 g of protein/day), the Social Nutrition Program (additional 27 g of protein/day and social network intervention), or a control group. Those assigned to the Social Nutrition Program group received individual counseling from 1 dietitian and 1 social worker during 6 home visits and were encouraged to participate in 4 sessions of community-based cooking activities, the social kitchen program. Primary outcomes were changes in Physical Functioning (PF) and the Timed Up and Go (TUG) test and were assessed at 0 months (baseline), 1.5 months (interim), and 3, 6, and 9 months (postintervention).

Results: Compared with the control group, participants in the Social Nutrition Program showed an average improvement of 2.2-3.0 s in the TUG test and this improvement persisted for 3 months after the end of the program (post hoc p ≤ 0.030). The Social Nutrition Program also increased PF by 1.3 points while the control group showed a 1.4 point reduction at the end of the program (post hoc p = 0.045). Improvement in PF and TUG results was primarily observed for the socially frail subgroup of older adults in the Social Nutrition Program group rather than the physically frail subgroup. Frequency of leaving home functioned as a mediator (p = 0.042) and explained 31.2% of the total effect of the Social Nutrition Program on PF change.

Conclusion: Our results indicate that social network intervention combined with protein supplementation can improve both the magnitude and duration of functional status among frail older community-dwelling adults.

Keywords: Health-based integrated approach; Homebound state; Mediation analysis; Number of times leaving home; Social frailty.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Dietary Supplements
Frail Elderly*
Frailty*
Humans
Independent Living
Social Networking