(P28-041-23) A 12-Week Nutrition and Physical Activity Program Improves Toe Strength Among Elderly Day Care Center Users in Korea: A Cluster Randomized Controlled Trial

Objectives: The aim of this study is to evaluate the effectiveness of a health promotion program in day care centers to improve toe strength for fall prevention among the elderly.

Methods: This study was conducted for 12 weeks from July 2022, and included 205 elderly individuals who used the day care center in Chuncheon, Korea. Ten centers were randomly assigned to an experimental group or a control group. The intervention groups were assigned as one of the following: nutrition intervention group with supplemental drinks with protein and nutrition education for key personnel at centers and elderly users, exercise group with guided daily toe exercise, and both of the nutrition and exercise components. Control groups received delayed intervention components after completing the post-intervention measurements. Toe grip strength, other basic anthropometric measures, and socio-demographic factors were measured before and after the program.

Results: The mean age of the participants was 83.4 years, and around 30% were male. Most of the center users had mild to moderate cognitive dysfunctions and multiple chronic health conditions. Both the intervention and control groups showed significant improvements in toe grip strength after the intervention. The post-pre change in toe grip strength was 1.9kg in the nutrition only group, 2.3kg in the exercise only group, and 2.2kg in the nutrition and exercise group, all statistically significant at 0.05 level according to paired t-tests. When compared to the control group, the change was only significant for the exercise only group and the nutrition and exercise group. Intervention compliance was acceptable for most of the intervention arms, except for some withdrawal rates due to the old age of participants. Some participants had to move to other facilities due to deteriorated health. Other than that, both nutrition and exercise components had positive responses from center staff and elderly users.

Conclusions: Toe strength is considered to be important for fall prevention among the elderly population, and it is necessary to develop and implement simple but effective nutrition and exercise measures in day care centers. This study showed that intervention targeting very old populations with mild to moderate cognitive disorder can be effective in improving toe strength.

Funding Sources: This research was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Chuncheon-si, Maeil Health Nutrition, Link+ 3.0.