Unit:
Κατεύθυνση Κλινικές Μελέτες: Σχεδιασμός και ΕκτέλεσηLibrary of the School of Health Sciences
Author:
Paraskevas Themistoklis
Supervisors info:
Σεργεντάνης Θεόδωρος, Επίκουρος Καθηγητής, Τμήμα Πολιτικών Δημόσιας Υγείας, ΠΑΔΑ
Ψαλτοπούλου Θεοδώρα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ντάνασης-Σταθόπουλος Ιωάννης, Εξωτερικός Συνεργάτης, Ιατρική Σχολή ΕΚΠΑ
Original Title:
Συμπληρώματα μικροθρεπτικών συστατικών στο σύνδρομο ευθραυστότητας: μια συστηματική ανασκόπηση και μέτα-ανάλυση τυχαιοποιημένων κλινικών δοκιμών
Translated title:
Micronutrient supplementation in frailty: a systematic review and meta-analysis of randomized clinical trials
Summary:
Introduction: Frail individuals are at risk of high morbidity and mortality. Low levels of a number of vitamins and minerals has been associated with higher frailty incidence and severity. Oral supplementation of these micronutrients is often used in clinical practice without enough backing evidence.
Objectives: To determine the effect of micronutrient supplementation on measures of physical frailty, mortality and other patient-related outcomes.
Methods: A systematic search in PubMed and Embase was conducted on September 2022 and randomized controlled trials investigating the effect of micronutrient supplementation in frail individuals were included. The GRADE guidelines were used to assess the certainty of available evidence.
Results: We included 18 studies described in 30 published articles, reporting on the effect of either Vitamin-D supplementation or multicomponent supplementation, which consisted of a number of micronutrients. Only 7 of 18 studies used a an established frailty scale to assess participants. Regarding risk of bias, overall quality of studies was moderate. For Vitamin D supplementation, 7 studies (2600 participants) reported all-cause mortality (RR: 1.04, 95% CI: 0.83 to 1.31, I2=35%) with moderate certainty of evidence, while only one study reported on change in frailty levels. For multicomponent supplementation, we found 4 studies (180 participants) on mortality and 2 studies on change in frailty levels (MD= -0.28, 95% CI: -0.71 to 0.16, I2=0%) with very low certainty of evidence for both outcomes.
Conclusion: Vitamin D supplementation probably leads to little or no change in all-cause mortality and fall incidence, while it may lead to little difference in fractures in frail individuals. For multicomponent supplementation, the certainty of evidence was very low for our main and secondary outcomes. Future research in frailty should focus on patient-related outcomes, such as change in frailty levels, cognitive function and functional measures.
Main subject category:
Health Sciences
Keywords:
Geriatrics, Nutritional suppplements, Vitamins, Micronutrients, Frailty syndrome
