Rationale: The dietary protein counselling of the VITAMIN trial showed to be effective in increasing the protein intake in community-dwelling older adults up to 1.41 g/kg/day after 6-months intervention and sustaining this intake up to 1.24 g/kg/day at 12-months. In this sub-analysis we determine how the increased protein intake was established. Methods: The VITAMIN (VITal AMsterdam older adults IN the city) RCT randomised older adults into: control, exercise, or exercise plus dietary counselling (protein) group. The dietary counselling intervention was blended, by use of face-to-face contacts and videoconferencing during a 6-month intervention, followed by a 6-month follow-up. Dietary intake was measured by a 3d dietary record at 0, 6 and 12 months (m). Sub-group analysis included characterisation of protein sources, product groups, resulting amino acid intake, and intake per meal moment. Linear Mixed Models were performed with SPSSv25; whereas time and time*group interaction were defined as fixed factors, and the protein group as reference.Results: In total 212 subjects were eligible for analysis (72.2 ± 6.3y), with an average protein intake at baseline of 77.8 (20) g/day and 1.08 (0.3) g/kg/day. Animal protein (g) accounted as major source (6m +25.6 (2.7) p<0.001 | 12m +15.6 (2.8) p<0.001), with the main increase in dairy products (g) (6m +14.2 (1.5) p<0.001 | 12m +10.0 (1.5) p<0.001), followed by fish and meat. This resulted in significant changes in amino acid intake: e.g. leucine (g) 6m +2.3 (0.3) p<0.001 | 12m +1.1 (0.3) p<0.001. Significant increased intake for the protein group was seen at all 6 meal moments, and particularly at breakfast (g) 6m +6.2 (1.0) p<0.001 | 12m +6.5 (1.1) p<0.001) and lunch (g) 6m +7.2 (1.3) p<0.001 | 12m +4.0 (1.3) p=0.003.Conclusions: Blended dietary counselling was effective in increasing protein intake in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch. Keywords: Ageing, Behaviour change, E-health, Nutrition, Protein
Home automation that allows for telecare services is increasingly becoming a tool to help older adults live independently and to improve perceived safety and security. The number of older adults receiving professional care, in relation to housing, on a daily basis is not very large. Only 15% receives home care, 5% lives in a care home, and about 2.5% resides in a nursing home. The majority of older adults live in the community. The Unattended Autonomous Surveillance system by TNO Defense is an integrated system that combines many functionalities for community-dwelling (older) adults, who are entitled to receiving nursing home care based on official assessments. The technology is implemented among people in the towns of Baarn and Soest in the centre of the Netherlands. The UAS system aims to support Ageing-in-Place and delaying the demand for expensive institutional care. Besides the benefits for the care recipient, informal or family carers are supported in care through the technology installed as well. Professional carers, for instance, home care, can benefit from the increased self care capabilities of the care recipient. In cases of emergency, i.e., when alarms are activated, people in the care centre can access the home via a camera. The aim is to study the perceptions of independent living, the role and quality of care received, and how people think technology can support them in their daily lives. This is the first round of interviewing on a total of three rounds. Methods In order to investigate the needs of the users, phenomenological qualitative research is carried out among a group of 30 independently living older adults (some with mild psychogeriatric health problems) and their (family) carers, using semi-structured questionnaires on home care received, demand for care, use and need of assistive technologies and perceived safety and security. The questionnaires were based on earlier work by Bijsterveld1 and Demeris et al.2. The first part of the study, performed between May and September 2007, included 14 subjects. The transcripts were analysed using the MAXQDA program. First, each transcript was read in its entirety. Then, they were read a second time to develop codes that were grouped into themes consistent with the interviews, which emerged from the narratives and the interview guides. To be considered a major theme, the code had to have appeared in more than 25% of the narratives and more than once in each of the narratives. Third, quotes that summarised the essence of each person’s subjective experience were recorded. Finally, a master list of themes from each interview was developed to allow for easy cross-interview examination. Results and discussion Preliminary results showed a positive attitude of older adults towards the system as a means to provide additional telecare and to increase perceived security in their surroundings. The fact that professional carers are immediately available after an emergency call, for instance via video communication, eases their feelings of insecurity. Family carers were more enthusiast about the system than many older adults, because the UAS system that is always present and vigilant takes away a part of the care burden. The over-time contribution of the UAS system to independence is to be studied.
An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019–October 2020. Protein intake was assessed by the Protein Screener 55+, indicating a high/low chance of a low protein intake (<1.0 g/kg body weight/day). The behavioral determinants of cognizance, knowledge, risk perception, perceived cues, attitude, social support, self-efficacy and intention were assessed by evaluating statements on a 7-point Likert scale. A total of 824 Dutch community-dwelling older adults were included, recruited via online newsletters, newspapers and by personal approach. Poisson regression was performed to calculate quartile-based prevalence ratios (PRs). Almost 40% of 824 respondents had a high chance of a low protein intake. Univariate analyses indicated that lower scores for all different behavioral determinants were associated with a higher chance of a low protein intake. Independent associations were observed for knowledge (Q4 OR = 0.71) and social support (Q4 OR = 0.71). Results of this study can be used in future interventions aiming to increase protein intake in which focus should lie on increasing knowledge and social support.
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