3rd IANA (International Academy on Nutrition and Aging) Meeting Nutrition, Exercise & Alzheimer and Clinical Trials on Sarcopenia August 1–2, 2008 Hyatt Regency Tamaya Resort 1300 Tuyuna Trail Santa Ana Pueblo, NM USA

3rd IANA (International Academy on Nutrition and Aging) Meeting Nutrition, Exercise & Alzheimer and Clinical Trials on Sarcopenia August 1–2, 2008 Hyatt Regency Tamaya Resort 1300 Tuyuna Trail Santa Ana Pueblo, NM USA

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  L ECTURES THE TASK FORCE ON PREVENTIVE TRIALS IN ALZHEIMER . S. Andrieu 1,2 (1. Inserm U558, Toulouse, France, 2. Department of Epidemiology and Public Health,Toulouse University Hospitals, France) Background : Prevention of neurodegenerative disease, such as Alzheimer disease(AD), is a growing public health problem and several potential factors (lifestyle, cognitivestimulation and preventive drugs) have been identified in large observational studies. Inorder to demonstrate the real effectiveness of these factors randomized controlled trials(RCTs) are needed but few RCTs were developed in the past and first results have so farbeen generally conflincting with those of epidemiological studies, perhaps due tomethodological issues. Such trials raise specific methods because they require largenumbers of subjects and lengthy follow-up periods. Methods ; We will present a systematicreview of RCTs for the primary prevention of neurodegenerative dementia or cognitivedecline. Trials involving only patients with dementia or some specific cognitiveimpairment were excluded from this review. The results of this systematic review and themethodological issues raised (target population, methods of recruitment, outcomes, follow-up period) were discussed during two meetings involving experts identified as specialistsin prevention trials for AD. The first meeting took place in Lisbon-Portugal, under theauspices of the EADC (European AD Consortium), and the second, involving NorthAmerican experts, took place in Albuquerque – NM,USA. Conclusion : The methodologyof primary prevention RCTs for neurodegenerative dementia is of great importance.Future trials may need to examine the effects of multiple interventions, especially thosefocused on lifestyle factors. THE METABOLIC SYNDROME IS A RISK FACTOR FOR VASCULARDEMENTIA BUT NOT FOR ALZHEIMER’S DISEASE, THE THREE-CITYSTUDY . P. Barberger-Gateau 1 , C. Raffaitin 1,2 , C. Berr 3 , C. Tzourio 4 , J.-F. Dartigues 1 , H. Gin 2 (1. Inserm, U897, Bordeaux, F-33076 France; Victor Segalen Bordeaux 2University, Bordeaux, F-33076 France; 2. Diabetology-Nutrition Unit, University Hospitalof Bordeaux, Pessac, F-33600 France; 3. Inserm, U888, Montpellier, F-34093 France; Montpellier 1 University, Montpellier, F-34093 France; 4. Inserm, U708, Paris, F-75651France) Background: The metabolic syndrome (MetS) is a cluster of five metabolic parameters(hypertension, high waist circumference, elevated triglycerides, low HDL-cholesterol,hyperglycaemia) associated with an increased risk of cardiovascular disease. This studyassessed the associations between the MetS, and its individual components, with risk of incident dementia. Methods: The 7087 community-dwelling participants aged 65 yr andover were recruited from a large French multicenter prospective cohort, the Three-Citystudy. The MetS was defined according to the National Cholesterol Education ProgramAdult Treatment Panel III Criteria. Incident cases of dementia were identified through atwo step screening based on neuropsychological testing and clinical evaluation, and thenconfirmed by an independent committee of neurologists. Hazard ratios (HR) of incidentdementia over four years associated with the Mets and its individual components wereestimated by Cox proportional hazard models. Results: The MetS was present in 15.8% of the study participants at baseline. During the four years of follow-up, 208 incident cases of all-cause dementia were validated including 134 cases of Alzheimer’s disease (AD) and 40cases of vascular dementia. The presence of MetS increased the risk of incident vasculardementia but not AD, independently of socio-demographic characteristics and ApoliproteinE ! 4 genotype. Hypertriglyceridemia was the only component of the MetS that wassignificantly associated with the incidence of all-cause dementia (HR = 1.45 [1.05 – 2.00];p = 0.02) and vascular dementia (HR = 2.27 [1.16 – 4.42]; p = 0.02), even after adjustmenton Apoliprotein E genotype. Instead, a high waist circumference was associated with adecreased risk of AD (HR = 0.63 [0.43 – 0.94]; p = 0.02). Conclusions: The relationshipbetween hypertriglyceridemia and vascular dementia emphasizes the need for detection of dyslipidemia in older persons. Further research is needed to ascertain whether treatinghypertriglyceridemia could decrease their risk of vascular dementia. YOUNGER AGE AT TIME OF DEMENTIA DIAGNOSIS FOR A COMMUNITY-BASED SAMPLE OF CALIFORNIA HISPANICS COMPARED TO WHITE NON-HISPANICS. L.J. Fitten 1,2,3,4 , F. Ortiz 1,2,3 , L. Fairbanks 1,4 , G. Bartzokis 1,4 , P. Lu 1,4,5 , J. Ringman 1,5 (1. Alzheimer Disease Research Center, David Geffen School of Medicine at UCLA; 2. Greater Los Angeles Veterans Affairs Healthcare System, Sepulveda Campus; 3. Department of Psychiatry Olive View-UCLA Medical Center; 4. Department of Psychiatry and Biobehavioral Sciences, School of Medicine at UCLA; 5. Department of  Neurology, David Geffen School of Medicine at UCLA) Background and purpose: The Hispanic elderly are vulnerable to develop diabetes,hypertension, dyslipidemia, obesity and other metabolic / vascular disorders. Theseconditions may increase the risks for dementia or could accelerate cognitive decline inelderly demented 4-8. The study’s purpose was to test the hypothesis that Hispanic elderson average are younger at time of dementia diagnosis than their White non-Hispaniccounterparts. Methods: 290 demented subjects aged > 50 (180 White non-Hispanics, 110Hispanics) were diagnosed for the first time as Alzheimer disease (AD) or vasculardementia (VascD). MMSE score ranged from mild (30-24), mild-moderate (23-17),moderate-severe (16-10), to severe (>9). Apolipoprotein genotype (APOE) and medicalhistories were also obtained. Results: Hispanics on average were younger than theircounterparts by approximately 4 years at time of diagnosis, regardless of dementia type.The earlier age at diagnosis for Hispanics could not be explained by gender, dementiaseverity, APOE status, years of education, or by the presence of diabetes, hypertension andhypercholesterolemia. Only ethnicity was the main predictor. Discussion: Compared toWhite non-Hispanics, demented Hispanics were significantly younger at time of diagnosisat all stages of illness severity. Among the various demographic, clinical and genotypicvariables considered, only ethnicity was of primary importance in predicting age atdiagnosis. Conclusion: Hispanic elders were diagnosed with dementia at a younger agethan their White non-Hispanic counterparts in this study. References: 1. He W, SenguptaM, VelKoff VA, DeBarros KA. U.S. Census Bureau, Current Population Reports, P23-209,65+ in the United States: 2005. Washington, DC.: U.S. Government Printing Office, 2005;2. Ramirez RR. We the People: Hispanics in the United States. Census 2000 SpecialReports. Washington, D. C.: U.S. Census Bureau, 2004:20; 3. Himes CL. ElderlyAmericans. Population Reference Bureau. 2002;56:44; 4. Bruce DG, Harrington N, DavisWA, Davis TM. Dementia and its associations in type 2 diabetes mellitus: the FremantleDiabetes Study. Diabetes Res Clin Pract. 2001;53:165-172; 5. Wu JH, Haan MN, Liang Jet al. Impact of diabetes on cognitive function among older Latinos: a population-basedcohort study. J Clin Epidemiol. 2003;56:686-693; 6. Panza F, Solfrizzi V, Colacicco AM etal. Cerebrovascular disease in the elderly: lipoprotein metabolism and cognitive decline.Aging Clin Exp Res. 2006;18:144-148; 7. Hassing L, Hofer, SM., Nilsson, SE., Berg, S.,Pedersen, NL., Mcclearn, G., and Johansson, B. Comorbid type 2 diabetes milletus andhypertension exacerbates cognitive decline: evidence from a longitudinal study. Age andAgeing. 2004;33:355-361; 8. Gregg EW, Yaffe K, Cauley JA et al. Is diabetes associatedwith cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med. 2000;160:174-180 PHYSICAL ACTIVITY AND COGNITIVE FUNCTION IN HUMANS. P.C. Heyn (Physical Medicine and Rehabilitation Department, School of Medicine, University of Colorado Denver, USA) The research on the effects of physical activity on brain behavior and function hasgrown substantially over the past ten years. Meta-analytic reviews of the literaturedemonstrate that physical activity is beneficial to the cognitive performance of older adults(Etnier et al., 1997; Colcombe & Kramer, 2003, Heyn et al., 2004). Recent prospectiveevidence suggests that a causal relationship with higher levels of physical activity beingpredictive of better performance on standardized cognitive tests (Albert et al., 1995; Dik et THE JOURNAL OF NUTRITION, HEALTH & AGING©  The Journal of Nutrition, Health & Aging© Volume 12, Number 7, 2008 419 3rd IANA (International Academy on Nutrition and Aging) Meeting Nutrition, Exercise Alzheimer and Clinical Trials on Sarcopenia August 1-2, 2008Hyatt Regency Tamaya Resort 1300 Tuyuna TrailSanta Ana Pueblo, NM USA  al., 2003; Lytle et al., 2004; van Gelder et al., 2004; Weuve et al., 2004) and of a lesser riskof clinical cognitive impairment (Abbott et al., 2004; Laurin et al., 2001; Podewils et al.,2005; Rovio et al., 2005; Yaffe et al., 2001) at subsequent testing times years later. Thepurpose of this presentation is to review current research that is designed to support therelationship between physical activity and cognitive function in older adults with cognitiveimpairments and at risk for Alzheimer’s disease. This presentation will include the latestresearch about the effects of exercise on Mild Cognitive Impairment (MCI), which is nowbelieved to represent a prodromal phase of AD in most instances (Petersen 2001, 2005;Morris 200; Bruscolli, 2004). This will be of value to IANA members because of the focuson exercise effects on metabolism and on how physical activity can serve as a lifestyleintervention to promote and protect cognitive function in older adults. Given the projectedincrease in prevalence of Alzheimer’s disease, this will provide information valuable toclinicians and allied health care professionals involved in the prevention and care of dementia. Presentation Main Objective(s): 1) to examine current evidence on the effectsof physical activity on AD and related cognitive impairments, 2) to review commonresearch issues related to AD physical rehabilitation, 3) to offer recommendations forexercise practice based on evidence from the literature. UNDERNUTRITION IN HOSPITALIZED OLDER ADULTS: PATTERNS ANDPREDICTORS, OUTCOMES, AND OPPORTUNITIES FOR INTERVENTION. J.L. Locher (Department of Medicine, Division of Gerontology, Geriatrics, and PalliativeCare, University of Alabama at Birmingham, USA) Undernutrition in older adults is a well-recognized and serious problem withsignificant health, economic, and social consequences. Older adults who are hospitalizedbecause of an acute illness may be at increased risk for experiencing undernutritionbecause of underlying illness, low dietary intake, or both. Undernutrition may be presentupon admission or acquired during hospitalization. Older adult hospital patients who areundernourished are at increased risk for experiencing adverse events while in the hospital,following discharge, or both. Routine nutritional assessment and intervention while in thehospital and following discharge may result in improvements in patient care and outcomesand reductions in health service utilization and costs. The purpose of this paper is topresent an overview of research that has been conducted examining undernutrition inhospitalized older adults. First, findings from observational studies examining patterns andpredictors of undernutrition in hospitalized older adults will be described. Highlighted inthis description will be a discussion of the methodological challenges of measuringundernutrition in the hospital setting. Second, clinical outcomes and costs associated withundernutrition in hospitalized older adults will be presented. Adverse events occurring bothwhile in the hospital and subsequent to discharge will be included in this discussion. Third,a description of interventions that have already been implemented in hospitalized olderadults will be described. Finally, future areas of inquiry and opportunities for evidence-based nutritional interventions targeted at older adults during and following hospitalizationwill be suggested. The emphasis of this discussion will focus on changes in clinicianbehavior and hospital practices. HEALTH PROMOTION PROGRAM AND NUTRITION IN ALZHEIMERDISEASEGY. THE NUTRIALZ STUDY. A. Salvà 1 , S. Andrieu 2 , E. Fernández, B. Vellas 2 (1. Institut de l’Envelliment (Institute on Aging). Universitat Autònoma de Barcelona. Barcelona. Spain; 2. Service de Gerontologie Clinique. Hospital PurpanCasselardit. Toulouse. France) Objective: To evaluate the positive impact of a nutritional program to reduce the lossof function in people with dementia living at home. Secondary aims: To Reduce weightloss, to Decrease the caregiver burden and to improve clinical practice of professionals inrelation to nutrition. Methodology: Cluster randomized multi centre study. 11 centers haveparticipated. All of these centers were Alzheimer outpatients or day care centers. 6 Centerswere randomized as Intervention centers and 5 as controls. Bbaseline assessment:sociodemographic and socioeconomic variables (age, gender, educational level, maritalstatus); diagnostic, treatments, MMSE, list of comorbid conditions; activities of dailyliving (ADL, IADL), Zarit Scale, breef-NPI, and nutritional status measured by the BMI,Mini Nutritional Assessment and the Eating Behaviour scale. Use if social and healthresources were assed by the RUD. Intervention: The intervention was multi-component.One part was focused on the professionals, were we agreed a common protocol. Thesecond part was focused on the families with different actuations: A briefcase withinformation and recommendations on nutrition and Alzheimer disease, 4 family sessionsand a system to help the families to follow the weight curve. Results: A total of 946persons participated in the study. 656 participants (70 %) completed the follow up at 12months. Of the 290 losers, 64% had to interrupt the study because they moved to aninstitution (31%), death (25%) or had medical complications (9%). Mean age was 78,99(SD 7,27) , 68,1 % were women; 44,9% lives with their partner; 74,2% has a dementia typeAlzheimer, and it has been 5,25 years since symptoms of dementia and 2,78 years since thediagnostic; mean MMSE score was 15,41 (SD 6,18); mean weight was 64,31 (SD12,52)kg; mean BMI was 26,96 (SD4,53) (<19: 2,8; 19-21:5,4; 21-23: 9,9: >=23:81.9). MeanADL without difficulties was 3,24/6(SD 2,09).; mean IADL without difficulties was 0,71/8(SD 1,56); mean number of symptoms in the NPI was 4,43 (2,59) severity score 7,87 (SD5,94) and distress score 11,33 (9,01); mean Zarit scale was 27,41 (SD15,50); mean MNAwas 23, 19 (SD 3,49). >17: 5,2 %, 17-23: 31,6 %, >=23: 63,2 %. MNA score decreasedwith increasing difficulty in the activities of daily living. The score of the MNA decreasedwith increasing dementia severity. Preliminary analysis of the principals results haven’tseen any statistically significant difference between the two groups at one year looking atthe change in the ADLs or in weight after adjusted for baseline MNA score, MMS, Zaritand ADL. Conversely the nutritional risk measured by the MNA of the control group wasincreased, whereas the risk of the intervention group was decreased after 1 year. 74% of families in the intervention group and 9 % in the control group said that they had receivedinformation and recommendations regarding nutrition and 67% and 9 % respectivelyreceived information on physical exercise. In the intervention centers (49%), they haverecommended diet supplements and complements in a higher percentage than in the controlcenters (5%). EFFECT OF FISH OIL SUPPLEMENTATION ON COGNITIVE PERFORMANCEIN OLDER SUBJECTS: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL . O. van de Rest, J.M. Geleijnse, F.J. Kok, W.A. van Staveren,A.T.F. Beekman, W.H.L. Hoefnagels, C.P.G.M. de Groot (Wageningen University, Division of Human Nutrition, Wageningen, The Netherlands) Introduction: High intake of n-3 polyunsaturated fatty acids may protect against age-related cognitive decline. However, results from epidemiological studies are inconclusiveand results from randomized trials in non-demented elderly are lacking. Methods: Double-blind, placebo-controlled trial involving 302 cognitively healthy (MMSE>21) individualsaged 65 years or older. Participants were randomly assigned to 1800 mg/d EPA-DHA, 400mg/d EPA-DHA, or placebo capsules for 26 weeks. The primary outcome was cognitiveperformance, which was assessed using an extensive neuropsychological test battery thatincluded the cognitive domains of attention, sensorimotor speed, memory and executivefunction. Analysis was by intention-to-treat. Results: Mean age of the subjects was 70years and 55% was male. Overall there were no significant differential changes in any of the cognitive domains for either 1800 mg or 400 mg EPA-DHA supplementation comparedto placebo. In a subgroup of 92 subjects who carried the APOE- ! 4 allele we observed asignificant improvement in the domain of attention after 26 weeks for the low-dose(p=0.03; 0.47 [95%CI 0.03-0.91]) as well as for the high-dose fish oil group (p=0.04; 0.49[0.01-0.96]) compared to placebo. A significant improvement in this domain was alsoobserved in men (n=167) in the low-dose fish oil group (p=0.05; 0.36 [0.01-0.72]).Conclusion: In this randomized double-blind placebo-controlled trial we observed no effectof EPA-DHA supplementation for 26 weeks on cognitive performance. However, our datasuggested that in subjects carrying the APOE- ! 4 allele and in men, EPA-DHA mayimprove attention. Based on these findings, longer-term EPA-DHA supplementationstudies to investigate effects on cognitive performance are warranted, especially in groupsat higher risk for cognitive decline. O RAL C OMMUNICATIONS PHYSICAL ACTIVITY AND ENHANCED FITNESS IMPROVE COGNITIVEFUNCTION IN OLDER PEOPLE WITHOUT KNOWN COGNITIVEIMPAIRMENT, A COCHRANE SYSTEMATIC REVIEW . M. Angevaren, G. Aufdemkampe, H.J.J. Verhaar, A. Aleman, L. Vanhees (University of Applied Science,Utrecht, the Netherlands) Several studies have shown that physical activity, cardiovascular fitness and cognitivefunction in older individuals are associated. The assumption is made that improvements incardiovascular fitness mediate the benefits in cognitive capacity. This Cochrane systematicreview intended to investigate the hypothesized link between physical activity aimed atimprovement of cardiorespiratory fitness and cognitive function. To assess theeffectiveness of aerobic physical activity on cognitive function in healthy people over 55years of age, the review included RCTs reporting activity, parameters of fitness andcognition within the same study design. We searched MEDLINE, EMBASE, PEDro,SPORTDiscus, PsycINFO, CINAHL, Cochrane Controlled Trials Register, Dissertationabstracts international and ongoing trials registers from their beginning to December 2005with no language restrictions. Eight out of 11 studies reported that aerobic exerciseinterventions resulted in increased cardiorespiratory fitness (VO2max) of the interventiongroup of approximately 14% and this improvement coincided with improvements incognitive capacity. The largest effects on cognitive function were found on motor functionand auditory attention, effect sizes (ES) of 1.17 and 0.52 respectively. Moderate effectswere observed for cognitive speed (ES 0.26) and visual attention (ES 0.26). Althoughaerobic exercise rendered significant effects on subcategories of cognition, the majority of comparisons yielded no significant results. There is evidence that aerobic physicalactivities are beneficial for cognitive function in healthy older adults. Larger studies arerequired to confirm whether the aerobic training component is necessary. The clinicalrelevance and reproducibility of such data would be enhanced if clinicians and scientists inthe field could agree upon the use of a smaller battery of cognitive tests. LET’S GIVE PEOPLE WITH ALZHEIMER’S (AD) WHAT THE BEAGLESGOT… HERE’S HOW ! S. Arkin (U. of Arizona, USA) For years, researchers have compared rats, mice and, most recently, dogs, who weregiven enriched environments and diets, with animals that got standard care, and – surprise!The animals that got better treatment performed better! Multiple studies have shown thathumans that exercise and engage in varied cognitive and social activities are at less risk fordementia. The U. of Arizona’s AD Rehab by Students program showed that people thatalready have dementia also benefit from multiple types of stimulation. This programprovided 2-8 semesters of student-administered fitness, memory, language, and volunteerwork interventions to 24 AD patients and compared them annually on global andneuropsychological measures with a similar untreated group from the CERAD The Journal of Nutrition, Health & Aging© Volume 12, Number 7, 2008 420  (Consortium to Establish a Registry for Alzheimer’s Disease) database. Those completing4-8 semesters showed no significant between year changes after their 1st year on theClinical Dementia Rating and on 5 or 6 cognitive measures. The AD Rehab group showeda slower rate of decline. Students got academic credit; caregivers got respite; communityagencies got volunteer help. The program can be replicated for the cost of a modestaddition to a faculty member’s salary and gym membership fees. Several published articlesdescribe details and outcomes (Arkin, 2003, 2005) and a video-illustrated manual isavailable to assist with replication (Arkin, 2005). (Arkin, S. (Jan. 05). Language-enrichedexercise for clients with AD. (Continuing Education course) Desert Southwest Fitness:Tucson, AZ. Arkin, S. (2003) Student led exercise sessions yield significant fitness gainsfor AD patients. American Journal of Alzheimer’s Disease and Other Dementias (AJAD),18, 159-170. Arkin, S (2007). Language-enriched exercise plus socialization slowscognitive decline in AD patients. AJAD, 22 (1) 1-16.) FRAILTY GRIP IS ASSOCIATED WITH GLUCOSE INTOLERANCE: RESULTSFROM THE EPIDEMIOLOGICAL DIABETES REDUCTION ASSESSMENTWITH RAMIPRIL AND ROSIGLITAZONE MEDICATION STUDYPOPULATION. H. Florez, H. Gerstein, P. Sheridan, J. Bosch, R. Goldberg (University of  Miami - Geriatrics Institute and Diabetes Research Institute, Miami, Fl, USA; McMasterUniversity - Department of Medicine, Hamilton, Ontario, Canada) Frailty is a physiological state of increased vulnerability to stressors associated withcomorbidities and disability and characterized by decreased grip strength (frailty grip). Todetermine the prevalence of frailty grip and its relationship with the presence of hyperglycemia we evaluated 24,595 subjects (60.4% women) in the Epidemiologicalfollow-up study of the Diabetes Reduction Assessment with Ramipril and RosiglitazoneMedication, a large, international, multi-center study. These subjects had an oral glucosetolerance test and grip strength measured at baseline. The prevalence of frailty grip,determined using as cutoffs the bottom quintiles of grip strength specific for sex anddegree of obesity, increased across the spectrum of glucose intolerance in both men (from17.8% in normoglycemic subjects to 23.3% in diabetics) and women (from 18.2% innormoglycemic subjects to 24.1% in diabetics). The presence of frailty grip was associatedwith age (Odds Ratio, OR= 1.47, 95% C.I.: 1.37-1.57), South Asian region (OR=3.90, 95%C.I.: 3.64-4.19) fasting plasma glucose "  126 mg/dl (OR=1.22, 95% C.I.: 1.10-1.36), and2-hour post-challenge plasma glucose "  200 mg/dl (OR=1.40, 95% C.I.: 1.27-1.53). Theseresults suggest that fasting and postprandial hyperglycemia are associated with decreasedgrip strength in subjects who have abnormal glucose values. One should consider thepresence of frailty grip and the assessment of sarcopenic-obesity in patients screened forglucose intolerance and diabetes. THE VALUE OF HIGH PROTEIN ORAL SUPPLEMENTS DURINGREHABILITATION OF GERIATRIC HIP FRACTURE IS RELATED TOREDUCED COMPLICATIONS AND POTENTIAL COST SAVINGS . K.M. Kaspar 1 ,S.M. Drawert (1. Nestlé Nutrition R&D Center Minneapolis, Nestlé HealthCare Nutrition, Inc., Minnetonka, MN, USA) Introduction/Objective: An intervention’s value resides in its ability to reducemortality, morbidity, or save money. Evidence was reviewed toward estimating the valueof early intervention with high protein oral nutritional supplements (HP ONS) during hipfracture recovery. Design/Methododology: The available clinical guidelines and medicalliterature were identified through the National Guideline ClearinghouseTM and Pubmed.Potential savings per hip fracture patient were calculated based on average rehabilitativecare cost for hip fracture (USD $13746 or CHF 16934), investment in 1 serving/d of HPONS during rehabilitative stay, and efficacy of a HP ONS to reduce rehabilitative stay (by20%) in comparison to an energy supplement. Results: Clinical practice guidelines fromESPEN and other premier associations recommend routine use of HP ONS for older adultsduring hip fracture recovery based on grade A evidence. This is consistent with themeasured reduction in unfavorable outcome from a Cochrane review of nutritionalsupplementation for older adults post hip fracture. For instance, use of HP ONS after hipfracture has been shown to reduce rehabilitative stay by up to 20%. Thus, an investment of USD $74 (CHF 91.3) for 1 serving/d of HP ONS during rehabilitative stay, has potential togenerate approximately USD $2692 per hip fracture patient in rehabilitative care costsavings. Conclusion/Discussion: The diffusion of best practices often takes 17 years tobecome standard clinical care. Given that the national healthcare burden of hip fracture isover USD $5 B per year, rapid adoption of early intervention with HP ONS deservesconsideration as a viable low cost solution for reducing the economic impact of hipfracture. Disclosure: Kala Kaspar and Susan Drawert are employees of Nestlé HealthCareNutrition, Inc., or its affiliates. INTRAMUSCULAR FAT IN OLDER ADULTS AND THE IMPACT OFRESISTANCE TRAINING. R.L. Marcus, J. Kidde, L. Dibble, O. Addison, P.C. LaStayo (University of Utah, Department of Physical Therapy, Salt Lake City, Utah, USA) Introduction: Sarcopenia is associated with increased total body fat as well as increasedfat within and around muscle. Intramuscular fat (IMF) is thought to increase with age andto negatively impact both mobility and metabolism in older adults. The impact of resistance training on IMF in older adults is not well known.Aims: To describe the 1)magnitude of IMF in the thigh muscles of adults with varying co-morbidities between 18and 87 years of age, and 2) impact of resistance training on both lean and IMF tissue of thethigh in individuals 55 years of age and older. Methods: Aim 1. Subjects (n=88), aged 18-87 years, included chronic stroke survivors, post-menopausal women with impairedglucose tolerance, cancer survivors, anterior cruciate ligament deficient individuals, andindividuals two years after a total knee replacement. Both IMF and lean tissue cross-sectional area were calculated from magnetic resonance imaging (MRI) scans. Aregression analysis between age and percentage of thigh IMF was performed. Aim 2. Asubset of these individuals over 55 years old (n=32, mean age 69) participated in a 12-week resistance training program. Paired t-tests were used to compare pre-training andpost-training MRI scans relative to changes in thigh IMF and lean tissue. Results: Asignificant (p<0.01) positive relationship exists between age and percentage of thigh IMF(r=0.47), suggesting that aging is associated with an increase in thigh IMF. A significant(p<0.05) decrease in thigh IMF (11.0%), and increase in thigh lean tissue (7.0%) wasfound in individuals 55 years and older who participated in a 12-week resistance trainingprogram. Conclusions: Skeletal muscle composition impacts both mobility andmetabolism. Fat within muscle increases with age and is associated with adverse healthconsequences in the elderly. Resistance training, in addition to increasing lean tissue, mayreduce IMF in older adults. Future studies should determine the functional and metabolicimpact of these changes. PHYSICAL ACTIVITY AND ALZHEIMER’S DISEASE IN A POPULATIONSTUDY. N. Scarmeas, Y. Stern, N. Schupf, J.A. Luchsinger (Columbia University Medical Center, USA) Background-Objective: We sought to explore the levels of physical activity (PA) of subjects diagnosed with Alzheimer’s disease (AD) in the community. We also investigatedwhether engagement in physical activity before AD onset is associated with altered risk forgetting AD in the future. Methods : A subset of a multiethnic community cohort of elderlyin New York underwent PA evaluations (number of minutes of weekly participation in[light, moderate or severe] physical activities; multiplied by Metabolic Equivalentscorresponding to each physical activity and categorized as PA low-middle-high tertiles).Subjects were also evaluated with standardized neurological and neuropsychologicalmeasures every ~1.5 years: 116 were diagnosed with AD at initial evaluation (prevalentAD), 101 developed AD during the course of 1.8 (± 0.8; [0.4-10.5]) years of follow-up(incident AD), while 1116 subjects never became demented. We examined PA as apredictor (reference group = low PA tertile) in logistic regression and survival-Cox models,with prevalent AD status and time to incident AD correspondingly as the outcomes. Allmodels were adjusted for cohort effect, age, gender, ethnicity, education, APOE genotype,a medical comorbidity index, caloric intake and body mass index. Results: As compared tothose who remained non-demented, participants with prevalent AD were physically lessactive (PA middle tertile Odds Ratio [OR] 0.66 [0.22-1.32]; PA high OR 0.47 [0.22-1.03];p for trend = 0.05). Risk for incident AD was lower for subjects with more PA at baseline(PA middle tertile Hazard Ratio 0.70 [0.40-1.22]; PA high tertile HR 0.53 [0.26-1.08]; pfor trend = 0.07). Conclusions: AD patients are less physically active than non-demented.Higher levels of physical activity before dementia symptoms are associated with lower riskfor developing AD in the future. Support: PO1-AG07232, AG028506. OLDER ADULTS' PERCEPTIONS ABOUT THE ROLE OF NUTRITION ANDDIET ON BRAIN HEALTH . J.R. Sharkey 1 , J.N. Laditka 2 , S.B. Laditka 3 , R. Liu 4 , A. Hochhalter 5 , J.F. Robare 6 (1. Texas Healthy Aging Research Network (TxHAN), Texas A&M Health Science Center School of Rural Public Health; 2. University of SouthCarolina HAN; 3. University of South Carolina HAN; 4. University of South Carolina HAN; 5. Scott & White Memorial Hospital and TxHAN; 6. University of Pittsburg HAN,USA) Background: The achievement and maintenance of good nutritional health, which isessential to functioning and quality of life among older adults, may be influenced by itsrelative importance to individuals. Although research suggests that good diets maypromote brain health, little is known about the attitudes about nutrition and brain healthamong older adults. Methods: Using grounded theory and constant comparisonmethodology, verbatim transcripts from 50 audio-recorded focus groups conducted in 2006by the Healthy Aging Research Network (HAN) in 9 U.S. states were independently codedand analyzed for themes, issues, and beliefs. Focus groups were composed of AfricanAmerican, Hispanic, non-Hispanic White, Vietnamese, and Chinese older adults, and wereconducted in urban and rural areas. Results: Groups generally reported eating at least asmany fruits and vegetables as others. Participants more commonly reported mediamessages about diet, especially dietary supplements, than any other factor. When asked,"How can we keep our brains healthy?", they rarely mentioned a good diet. Wheninformed that research suggests healthy diets may promote brain health, participants saidthey would improve diets, but were uncertain about their commitment. They emphasizedthat environmental barriers to good nutrition were common. Additional areas of discussionincluded concerns about ability to stay sharp with age and the role of the media ininforming people of ways to maintain brain health. Conclusions: Aging Americans areinterested in brain health, but uncertain about their ability to follow recommended healthbehaviors. Public policies may promote good nutrition for brain health. HIGH-FAT FEEDING AND AGE IMPACT VOLUNTARY WHEEL RUNNINGAND COGNITIVE FUNCTION IN RATS. N. Tümer, M. Judge, T.C. Foster, B. Erdos,I. Cudykier, P.J. Scarpace (Geriatric Research, Education and Clinical Center, Dept. of Veterans Affairs Medical Center Medical Center and Dept. of Pharmacology, University of Florida, Gainesville, FL, USA) Obesity is a risk factor for Alzheimer’s disease as well as disability. We examined theimpact of high-fat (HF) feeding on cognitive function and voluntary wheel running (WR)in young (5-month) and aged (26-month) F344xBN rats provided a HF diet (60% fat; 5.2kcal/g) or standard chow (15% fat; 3.3 kcal/g) for 5-months. HF fed animals exhibited The Journal of Nutrition, Health & Aging© Volume 12, Number 7, 2008 421  greater weight gain compared with chow. Final body weights were 415±12 vs 471±14 g,young; and 545±25 vs 631±14 g, aged). After 13 weeks, an object recognition test wasperformed. Memory retention was exhibited in both the young and aged rats on the chowdiet (discrimination indexes of .25 ± .09, .42 ± .07, respectively). There was a tendency forthe young rats on the HF diet to have reduced memory (P=0.06), and memory wassignificantly impaired in the aged, HF fed rats (P<0.05). WR activity, examined after 18weeks, decreased by 87% with age (1077±139 vs 135±22 meters/day, P<0.001), and nearly50% with HF feeding in the young rats (576±72 M/day, P<0.001). In aged rats, there wastendency towards a further decrease with HF (82±28 M/day). These data indicate that high-fat feeding decreases cognitive function in aged high-fat fed and decreases WR in younghigh-fat fed rats. Whereas age greatly affects WR activity, high-fat feeding in aged ratsonly marginally further decreases WR activity. These data indicate high-fat feedingimpacts both cognitive function and physical activity, but differentially with age.Supported by VA Medical Research, NIH AG-26159, P30 AG028740. LOW LEVELS OF PLASMA PHOSPHATIDYLCHOLINE DOCOSAHEXAENOICACID ARE ASSOCIATED WITH RISK OF ALL-CAUSE DEMENTIA ANDALZHEIMER’S DISEASE: THE RANCHO BERNARDO STUDY. L.A. Weiss, J. Bergstrom, D. Kritz-Silverstein, Elizabeth Barrett-Connor (Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, USA) Background: Diet may play an important role in the etiology of dementia andAlzheimer Disease. Several studies suggest that omega-3 fatty acids may protect the brainfrom dementia. Objective: We examined the relation of plasma phosphatidylcholinedocosahexaenoic acid (PC DHA) levels on risk of all-cause dementia and Alzheimer’sDisease in older adults. Methods: This nested case-control study included 276 men andwomen aged 67-100 (mean: 80) years from the Rancho Bernardo Study who wereevaluated in 1991-93 for all-cause dementia and Alzheimer’s Disease. Diagnoses werebased on a neurological and neuropsychological evaluation using the Criteria of theNational Institute of Neurological and Communicative Disorders and Stroke and theAlzheimer’s Disease and Related Disorders Association. Plasma PC DHA was measuredby gas chromatography in blood. Logistic regression analyses were used to test theassociation of PC DHA on risk of all-cause dementia and Alzheimer’s Disease. Results:There were 45 cases of all-cause dementia and 33 cases of possible or probableAlzheimer’s Disease. In age- and sex-adjusted analyses, the lowest quartile of PC DHAwas associated with a 2.29 (95% Confidence Interval (CI): 1.09, 4.83) increased odds of all-cause dementia, and a 2.52 (95% CI: 1.11, 5.72) increased odds of Alzheimer’s Diseasecompared to the three higher quartiles. Additional adjustment for apolipoprotein E andeducation did not materially change these associations. Conclusion: This study offersadditional evidence that docosahexaenoic acid appears to protect against dementia. Clinicaltrials of dietary or supplemental docosahexaenoic acid are warranted. ROLE OF DHA IN COGNITIVE AGING AND ALZHEIMER’S DISEASE. K. Yurko-Mauro 1 , E. Nelson 1 , J. Quinn 2 (1. Martek Biosciences Corporation, Columbia, Maryland; 2. Oregon Health and Science University, Portland, Oregon, USA) DHA is the principle long chain omega-3 fatty acid in brain and retina and plays animportant role in neural and visual development. DHA is an integral component of neuralmembrane phospholipid and is involved in multiple neuronal functions includingmembrane fluidity, ion fluxes and signal transduction pathways. Dietary consumption of DHA (fatty fish, organ meats) is low (<70mg/d) in Western diets versus intakes worldwide.Decreases in plasma DHA are associated with cognitive decline in healthy elderly (1) andAlzheimer’s patients (2). Greater DHA intake and greater plasma DHA levels are inverselycorrelated with relative risk of incident Alzheimer’s disease (AD) (3) and all-causedementia (4). Many epidemiological studies have verified these findings and will bereviewed in this presentation. Aged animal models and transgenic Alzheimer mousemodels (5,6,7) have demonstrated significant effects of DHA supplementation in elevatingDHA brain levels, reducing behavioral memory deficits and reducing brain amyloid andtau levels. A review of recent animal work will be presented. Clinical studies of the effectsof DHA as a nutritional neuroprotective agent in age-related cognitive decline and astherapy for mild to moderate Alzheimer’s disease are currently underway. An overview of current clinical studies will be given and baseline/demographic data of some of theongoing studies will be presented. References: 1. Heude B, Ducimetiere P, Berr C.Cognitive decline and fatty acid composition of erythrocyte membranes-- The EVA Study.Am J Clin Nutr 2003; 77: 803-808; 2. Tully AM, Roche HM, Doyle R, et al. Low serumcholesteryl ester-docosahexaenoic acid levels in Alzheimer's disease: a case-control study.Br J Nutr 2003; 89: 483-90; 3. Morris MC, Evans DA, Bienias JL, et al. Dietary Fats andthe Risk of Incident Alzheimer Disease. Arch Neurol 2003; 60: 194-200; 4. Schaefer, E.,Bongard, V., Beiser, A., et al. Plasma Phosphatidylcholine Docosahexaenoic Acid Contentand Risk of Dementia and Alzheimer Disease. Arch Neurol 2006; 63: 1545-1550; 5. CalonF, Lim GP, Yang F, et al. Docosahexaenoic Acid Protects from Dendritic Pathology in anAlzheimer's Disease Mouse Model. Neuron 2004; 43: 633-645; 6. Lim GP, Calon F,Morihara T, et al. A diet enriched with the omega-3 fatty acid docosahexaenoic acidreduces amyloid burden in an aged Alzheimer mouse model. J Neurosci 2005; 25:3032-40;7. Green,K. Martinez-Coria, H. Khashwji, H. et al. Dietary Docosahexaenoic Acid andDocosapentaenoic Acid Ameliorate Amyloid- #  and Tau Pathology via a MechanismInvolving Presenilin 1 Levels. J Neurosci 2007; 27(16):4385– 4395. TESTOSTERONE AND GROWTH HORMONE IMPROVE BODYCOMPOSITION AND MUSCLE PERFORMANCE IN OLDER MEN: THEHORMA TRIAL. F.R. Sattler 1,4 , C. Castaneda-Sceppa 2 , E.F. Binder 3 , E.T. Schroeder 4 , Y. Wang 5 , S. Bhasin 6 , M. Kawakubo 5 , Y. Stewart 1 , C. Hahn 5 , P. Colletti 7 , R. Roubenoff  2 ,K.E. Yarasheski 3 , S.P. Azen 5 (1. Department of Medicine; 4. Division of Biokinesiology, 7. Department of Radiologyg; 5. Department of Preventive Medicinee, of the University of Southern California, Los Angeles, CA; 2. Jean Mayer USDA Human Nutrition ResearchCenter on Aging of Tufts University, Boston, MA; 3. Department of Medicine, WashingtonUniversity, St. Louis, MO; 6. Section of Endocrinology, Diabetes, and Nutritionf, BostonUniversity, Boston, MA, USA. National Clinical Trials Number: NCT00183040) Context: Impairments in the pituitary-gonadal axis with aging are associated with lossof muscle mass/function, fat accumulation, cardiovascular complications and reducedquality of life. Objective: Test the hypothesis that physiologic supplementation withtestosterone and growth hormone together improves body composition and function in 65-90 year-old men with low testosterone and IGF-1. Design: Factorial (2X3) two tiered,randomized, double masked investigation. Setting: Three university research centerslocated in the western, central and eastern United States. Study Participants: 122community dwelling men 70.8±4.2 years-of-age with BMI 27.4±3.4kg/m2, testosterone $ 550ng/dL, and IGF-1 in lower adult tertile ( $ 167ng/dL) were enrolled and randomized;112 completed the study. Interventions: Transdermal testosterone (5g or 10g/day) duringsuppression of endogenous testosterone with leuprolide acetate (7.5mg/monthly) andgrowth hormone (0, 3, or 5ug/kg/day) for 16 weeks. Main Outcome Measures: Bodycomposition, muscle performance, and safety tests. Results: By week 17, total lean massincreased (1.0±1.7kg-to-3.0±2.2kg) as did appendicular lean tissue (0.4±1.4kg-to-1.5±1.3kg), whereas total fat mass decreased (0.4±0.9kg-to-2.3±1.7kg) as did trunk fat(0.5±0.9kg-to-1.5±1.0kg) for the six groups (p<0.05 for 22 of 24 within groupcomparisons) and by dose levels for the four parameters (p<0.05 for linear trend).Maximum voluntary strength of upper and lower body muscles increased by 14±34% to35±31% (p<0.05 in four highest dose groups) that correlated with changes in appendicularlean mass. Aerobic endurance increased (p<0.05) in all six groups (average 96±137seclonger). Systolic and diastolic blood pressure increased similarly in each group (p<0.05)with mean increases of 12±14 and 8±8mmHg, respectively. Other predictable adverseevents were minor-to-modest and reversible. Conclusions: Combined supplementation withtestosterone and growth hormone to achieve youthful levels produced significant gains intotal and appendicular lean mass, muscle strength, and aerobic endurance with significantdecreases in whole body and trunk fat with expected adverse events. P OSTERS MILD CONTINUOUS EXERCISE ENHANCES THE ACTIVITY OF NEUTRALSERINE PROTEASES IN GRANULOCYTES THAT REGULATEBIOPHYLAXIS. Y. Aoki, T. Yamamoto, T. Otuka (Department of Food and HealthScience, Faculty of Human Life Science, Jissen Women’s University, Tokyo, Japan) Mild exertcise of long periods increased neutral serine protease activity in granulocytesthat regulate biophylaxis. Mice were forced to exercise by running wheel for 30 min/dayin 6 days per week. After 3, 6 and 9 months bone marrow cells were obtained from bothtibias and femurs. They were layered on the top of Percoll (specific gravity 1.089) andcentriguged at 27,000xg for 20 min. The layer mainly consisted of mature granulocyteswas collected and the percent of mature granulocytes was counted. Mature granulocyteswere sonicated and centrifuged. From the precipitate proteases were extracted with 0.5Mpotassium phosphate buffer (pH7.0) at 37 %  for 30 min. Medullasin activity wasdetermined by employing apo-ornithine transaminase as substrate (1). Cathepsin G activitywas measured by determining the release of p-nitroaniline from N-succinyl-(ala)2 –pro-phe-p-nitroanilide as substrate (2). Both medullasin and cathepsin G activity ingranulocytes increased significantly as compared with those of sedentary controls after 3months. The increase was more prominent in 6 and 9 months exercise than in 3 months.The amount of GM-CSF in plasma determined by the ELISA development kit wassignificantly elevated in exercise mice than that of sedentary controls. Both medullasinand cathepsin G in granulocytes were shown to increase biophylactic activity (1,2).These results indicate that mild exercise of long periods enhances biophylactic activitythrough elevation of the activity of neutral serine proteases in granulocytes such asmedullasin and cathepsin G. References: 1. Y. Aoki et al , J. Clin. Invest. 69,1223-1230,1982; 2. T Yamazaki, Y. Aoki, Immunology, 93,115-121, 1998. A RANDOMIZED CONTROLLED TRIAL ON EARLY PHYSIOTHERAPYINTERVENTION VERSUS USUAL CARE IN ACUTE UNIT FOR ELDERLY.POTENTIAL BENEFITS IN LIGHT DIETARY INTAKES. C. Blanc-Bisson, I. Bourdel-Marchasson (CHU Bordeaux, Pôle de gérontologie, Hôpital Xavier Arnozan,33600 Pessac, France) Objective: to evaluate effect of early intensive physiotherapy rehabilitation onspecified primary outcomes: maximal and sustained isokinetic strength at clinical stabilityand Secondary outcomes: weight loss, current weight, energy intakes, protein intakes,autonomy, mobility. Design: prospective randomized controlled trial with 2 arms: earlyintensive physiotherapy rehabilitation and usual care. Intervention until clinical stabilitywith primary outcomes measured after intervention. Setting: patients aged 70 years andolder living in community, bedsores or reduced mobility but autonom within 3 months. The Journal of Nutrition, Health & Aging© Volume 12, Number 7, 2008 422  Patients with uncontrolled disease or limiting mobility pathology were excluded. Patients:a total of 76 patients were accrued, 55 women and 21 men; mean age was 85.4 years.Measurements: hospitalization length stay, bedsores status, arm and leg circumference,triceps skin fold, usual weight, body mass index, dietary intakes (Kcal/kg/D, g proteinconsumption/kg/D previous and after intervention), falls during hospitalization, 10 meterwalking time and step number, Tinetti test, get up and go test. endurance coefficient,fatigue index, plantarflexors, knee flexors and extensors repetitions, right handdynamometer. Results: Only for patients from early intensive physiotherapy groupcorrelation was establish between leg circumference and dietary intakes (r=-0.577,p=0.020), protein consumption (r=-0.534, p=0.030), walking Tinetti test (r=0.570,p=0.021) after intervention. Patients from usual care group had higher dietary intakes(Kcal/kg/D) (p=0.022) and protein consumption (g/kg/D) (p=0.016) whereas patients fromearly physiotherapy group had higher BMI (p=0.051) at this time. There were no differencein other clinical status, walking and physiotherapy performance tests. Conclusion:Intensive early rehabilitation physiotherapy correlate leg circumference and walkingTinetti test, daily dietary intakes, protein consumption after 1 month of hospitalization incomparison with usual care. WHO ARE THE MALNOURISHED CLIENTS IN HOME CARE? FACTORSASSOCIATED WITH MALNUTRITION INDICATORS USING THE RESIDENTASSESSMENT INSTRUMENT FOR HOME CARE (RAI-HC) . M.A. Bocock, H.H. Keller (University of Guelph, Canada) Objectives: The purpose of this study was to determine the prevalence of malnutritionmeasured by RAI-HC nutrition and hydration items and to determine other factorsindependently associated with this risk in older home care clients. Participants: RAI-HCdata for all first assessments for clients aged 65 years and older (n = 4552) collected from1999 to 2001, by 12 community care access centres (CCACs) in Ontario, Canada wereincluded for analysis. Design and Measurements: Malnutrition was defined as the presenceof any one of significant unintentional weight loss, cachexia, a noticeable decrease in foodor fluid intake, or consuming one or fewer meals per day. Other items on RAI-HCassociated with malnutrition were identified with bivariate analyses (p<0.0001) andregression analyses were completed in an attempt to identify independent predictors.Results: Overall malnutrition for older adults was 14%. Almost 10% (n = 442) of theseclients reported weight loss; cachexia was rare (1%) and less than 5% ate infrequent mealsor reported decreased dietary intake. The fully adjusted logistic model for malnutrition(Wald &  (14, N = 4551) = 832.76, p < .0001; c = .84) included the following factors: lossof appetite(OR 6.29, 95% CI 4.98-7.93), dysphagia, (OR 1.88, 95%CI 1.48-2.40),insufficient fluid intake (OR 13.91, 95%CI 9.29-20.85), end-stage disease (OR 12.60,95%CI 8.02-19.81), perceived health status (OR 2.77, 95%CI 2.31-3.31), self reportedpoor health (OR 1.75, 95%CI 1.43-2.15), functional decline (OR 2.09,95%CI 1.64-2.66),mood status (OR 1.32, 95%CI 1.04-1.69), social functioning (OR 1.22, 95%CI (0.98-1.51),cognitive performance (OR 1.05, 95%CI 0.81-1.37), and trade-offs (OR 2.22, 95%CI 1.29-3.83). Conclusions: Based on selected malnutrition indicators used in the RAI-HC, theprevalence of malnutrition appears to be low when compared to similar populations. OtherRAI-HC items associated with overall malnutrition indicators may be useful fordetermining ‘malnutrition risk’ and developing future malnutrition screening indices forolder adults receiving home care that identify older clients sooner. A PLASMA PANEL OF NUTRIENT BIOMARKERS IS MORE RELIABLE THANFFQ IN SUBJECTS AT RISK FOR DEMENTIA. G. Bowman 1 , J. Baxter 1 , B. Oken 1 ,B. Frei 2 , M. Traber 2 , S. Leonard 2 , J. Kaye 1 , J. Shannon 3 , J. Quinn 1 (Department of 1. Neurology and 3. Endocrinology, Oregon Health & Science University; 2. Linus Pauling Institute, Oregon State University, USA) Objective: To examine reproducibility of plasma nutritional biomarkers and nutrientestimates from NCI Diet History Questionnaire (FFQ) in subjects at risk for dementia.Background: Nutrients implicated in the pathogenesis include antioxidants, the dietarydeterminants of serum homocysteine, omega 3 fatty acids and cholesterol. It remainsunclear whether modification of these dietary factors reduces the risk of cognitive decline,in part because practical and reliable instruments for assessing nutrient status in high-risksubjects are not available. Methods: Thirty-eight subjects (19 amnestic-Mild CognitiveImpairment, 19 Non-Impaired Elderly) participated in an observational study of nutrientstatus derived from plasma and FFQ collected together at two time points one month apart.Results: Fifty-percent of the 12 nutritional biomarkers were more reproducible than serumcholesterol (ICC>.82) while Eicosapentaenoic acid was the sole FFQ derived nutrient tomeet this standard (ICC=.96). FFQ was more reproducible in MCI than cognitively intactelderly for antioxidants (mean ICC=.84 vs .73 in NIE), B vitamins (MCI=.65 vs NIE=.53),fatty acids (MCI=.85 vs NIE=.70) and cholesterol (MCI=.78 vs NIE=.52). FFQ derivedestimates of DHA (p=.02) and EPA (p=.03) correlated with their respective plasmameasures. Lower plasma EPA (p=.04) and higher gamma-tocopherol (p=.005) wereappreciated in MCI compared to controls. Vitamin B6, total Omega 3, total omega 6 /omega 3, ascorbic acid, DHA, and alpha-tocopherol trended toward difference in thegroups. Conclusions: Using serum cholesterol as a benchmark, we found a greaterproportion of nutritional biomarkers meeting this standard compared to nutrient estimatesfrom FFQ. The lack of association between many of the plasma and FFQ nutrientschallenges validity of FFQ in this setting. Nutritional biomarkers are reliable and worthyof larger prospective study in subjects at risk for dementia. Acknowledgements: UL1RR024140 (GB, JQ), Oregon Tax Check-Off Alzheimer’s Fund (GB), NCCAM T32AT002688 NRSA (GB, BO), NIA-AG08017 (JK). BODY COMPOSITION IN SWEDISH OLD PEOPLE AGED 65-99 YEARS,LIVING IN RESIDENTIAL CARE FACILITIES. M. Carlsson 1 , Y. Gustafson 1 , S. Eriksson 1 , H. Littbrand 1 , L. Håglin 2 (1. Department of Community Medicine and  Rehabilitation, Geriatric Medicine; 2. Department of Public Health and Clinical Medicine,Family Medicine, Umeå University, Umeå, SE-901 85, Umeå, Sweden) Background: It is important to evaluate body composition changes in subjects with anexisting multi-system reduction in capacity, as a small decrease in fat-free mass can causeserious impairments. Objective: The aim of the study was to describe body composition inold people living in institutions, using Bioelectrical Impedance Spectroscopy (BIS).Methods: Body composition data were collected in a study of 173 subjects with functionaland cognitive impairment, aged 65 to 99 years, living in residential care facilities. Animpedance spectrometer (Xitron Hydra 4200; 5 to 1000 kHz) was used to assess theamount of both fat-free and fat mass. Height was adjusted for by a calculating fat-free massand fat mass index (kg/m2). The Harpenden caliper and a tape measure were used to assessbody fat, arm-fat and arm-muscle area (mm2). Mini Nutritional Assessment (MNA) wasused for assessment of nutritional status. Results: A large proportion of the study subjectswas at risk of malnutrition or was malnourished. The amount of both fat-free and fat masswas inversely related to age, significantly in women but not in men. Bioelectricalimpedance spectroscopy and anthropometry provide comparable information about bodycomposition, except for fat mass. Conclusion: These selected population of old,functionally impaired people with multiple diseases, were at risk of malnutrition or werealready malnourished. Women, had significantly lower FFM and higher FM, inverselyrelated to age, than men. Bioelectrical impedance spectroscopy and anthropometricalmeasurements, seem to be comparable, except for FM%, which could be underestimatedby skinfold thickness values and/or overestimated by BIS. ASSOCIATIONS BETWEEN NUTRITION AND COGNITIVE FUNCTIONING INOLDER ADULTS. V. Danthiir 1 , C. Wilson 1 , T. Nettelbeck 2 , N. Burns 2 , G. Wittert 2 , M. Noakes 1 , P. Clifton 1 (1. Human Nutrition, Commonwealth Scientific and Industrial Research Organisation, Adelaide, Australia; 2. University of Adelaide, Australia) Research indicates a possible role for nutrition in the maintenance of cognitivefunctioning in older age. We are conducting a parallel, randomised, double-blind, placebo-controlled 18-month clinical trial (N=395), supplementing normal community-dwellingolder adults (65-90 years) with long-chain omega-3 polyunsaturated fatty acids. Cognitivefunctioning is assessed comprehensively; factor scores represent the domains of workingmemory, fluid intelligence, short-term memory, long-term memory and retrieval,inhibition, processing speed and perceptual speed. These results report the baselineassociations between the cognitive domains and a number of nutrients (e.g., omega-3 fattyacids, B vitamins), reflecting both systemic status and intake estimated from foodfrequency questionnaires, and health-related bio-markers. A COMPARISON OF CHANGES IN BODY MASS INDEX OVER TIME IN ON-PUMP AND OFF-PUMP CABG PATIENTS. R.A. DiMaria-Ghalili (Hartford Center for Geriatric Nursing Excellence, University of Pennsylvania, USA) Older adults experience weight loss the first six weeks after coronary artery bypassgrafting (CABG) surgery and the more weight lost the lower their self-reported physicalhealth as well as hospital readmission. Weight loss is a risk factor for malnutrition.Ischemia-reperfusion injury associated with the use of the cardiopulmonary bypass pump(CPB) during traditional (on-pump) CABG surgery causes catabolism. Off-pump surgeryis performed without the use of CPB, avoiding the adverse effects of CPB. This studyexplored the extent to which the weight loss is attributed to the catabolism associated withCPB by comparing changes in weight (as measured by body mass index {BMI}) forgender, age (< 65 vs > 65 years), and pump status (on-pump vs off-pump) in primaryisolated CABG patients using a longitudinal descriptive design. The total sample of 44(mean age 64.32 + 9.026) included 22 cases (off-pump) and 22 age-matched controls (on-pump) of which there were 24 older and 20 younger participants. Within participants, BMIchanged over time from preoperative, post-operative day 5 and 4-6 weeks post-discharge,F=3.88 , p=0.030, regardless of age. The effect of pump status was not statisticallysignficant, although trends indicate off- pump patients had the smallest change in BMIbetween postdischarge and preoperative, than the on-pump patients (-0.25 + 1.07 vs -0.8+1.42, respectively). Although the off-pump patients lost less weight over time than on-pump patients, this is not statistically signficant. Further study is needed to determine themechanisms underlying weight loss in older post-operative CABG patients. EFFECT OF CALCIUM, FOLATE AND VITAMIN D3 FORTIFIED MILK ONNUTRITIONAL STATUS AND MARKERS OF INFLAMMATION ANDIMMUNITY IN AUSTRALIAN AGED CARE RESIDENTS. J.A. Grieger, C.A. Nowson, N.T. Wattanapenpaiboon (School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia) In residential care, inadequate calcium and folate intakes; and low serum vitamin D(25(OH)D) concentrations are common. There is accumulating evidence to indicate thatageing is associated with dysregulated immune and inflammatory responses. We assessedwhether daily provision of calcium, folate and vitamin D fortified milk for six monthsimproved vitamin D status (and markers of inflammation and immunity: (Interleukin-6,tumor necrosis factor alpha, C-reactive protein, insulin-like growth factor-I (IGF-1)), in agroup of Australian aged care residents. One hundred and seven residents (61% female) The Journal of Nutrition, Health & Aging© Volume 12, Number 7, 2008 423
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