Effects of multicomponent training and HMB supplementation on disability, cognitive and physical function in institutionalized older adults aged over 70 years: a cluster-randomized controlled trial

Héctor Gutiérrez-Reguero; Ángel Buendía-Romero; Francisco Franco-López; Alejandro Martínez-Cava; Alejandro Hernández-Belmonte; Javier Courel-Ibáñez; Ignacio Ara; Julian Alcazar; Jesús G Pallarés

doi:10.1016/j.jnha.2024.100208

Effects of multicomponent training and HMB supplementation on disability, cognitive and physical function in institutionalized older adults aged over 70 years: a cluster-randomized controlled trial

J Nutr Health Aging. 2024 Mar 14;28(5):100208. doi: 10.1016/j.jnha.2024.100208. Online ahead of print.

Authors

Héctor Gutiérrez-Reguero¹, Ángel Buendía-Romero¹, Francisco Franco-López², Alejandro Martínez-Cava², Alejandro Hernández-Belmonte², Javier Courel-Ibáñez³, Ignacio Ara¹, Julian Alcazar¹, Jesús G Pallarés⁴

Affiliations

¹ GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain; CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain.
² Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
³ Department of Physical Education and Sport, University of Granada, Granada, Spain.
⁴ Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain. Electronic address: jgpallares@um.es.

PMID: 38489992
DOI: 10.1016/j.jnha.2024.100208

Abstract

Objectives: To investigate the synergist effects of exercise and β-hydroxy β-methylbutyrate (HMB) supplementation on disability, cognitive and physical function, and muscle power in institutionalized older people.

Design: Cluster-randomized controlled trial.

Participants: Seventy-two institutionalized older adults (age = 83 ± 10 years old; 63% women) were randomized in four groups: exercise plus placebo (EX), HMB supplementation, EX plus HMB supplementation (EX + HMB), and control (CT).

Intervention: The exercising participants completed a 12-week tailored multicomponent exercise intervention (Vivifrail; 5 days/week of an individualized resistance, cardiovascular, balance and flexibility program), whereas the HMB groups received a drink containing 3 g/day of HMB.

Measurements: Participants were assessed Pre and Post intervention for disability and cognitive function (validated questionnaires), physical function (short physical performance battery, SPPB), handgrip strength and sit-to-stand relative muscle power. Linear mixed-effect models were used to compare changes among groups.

Results: Compared to baseline, both EX and EX + HMB improved cognitive function (+2.9 and +1.9 points; p < 0.001), SPPB score (+2.9 points and +2.4 points; p < 0.001) and relative muscle power (+0.64 and +0.48 W·kg^-1; p < 0.001), while CT and HMB remained unchanged (p > 0.05). Significant between-group differences were noted between CT, EX and EX + HMB for cognitive function (p < 0.01), between CT and EX + HMB for physical function (p = 0.043), and between CT, EX and EX + HMB for relative muscle power (p < 0.001).

Conclusion: The Vivifrail exercise program was effective in improving cognitive and physical function, and muscle power in nursing home residents, while HMB supplementation did not provide additional benefits when combined with exercise. These results emphasize the importance of physical exercise interventions in very old people as an essential basis for improving their overall health and quality of life.

Keywords: Aging; Beta-hydroxy-beta-methylbutyrate; Exercise training; Lower-limb power; Nursing home.