Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Protein-enriched, Milk-based Supplement to Counteract Sarcopenia in Acutely Ill Geriatric Patients Offered Resistance Exercise Training During and After Hospitalisation - a Double-blinded, Randomized Controlled Trial
Brief Summary: The purpose of the study is to investigate if an increased protein intake, in the form of a protein-enriched, milk-based supplement, can enhance the beneficial effect of resistance training, offered during hospitalization and 12 weeks post discharge, in older patients. This will in part be evaluated from measures of muscle strength, muscle mass and physical functioning. Also, the study population's acceptance of the intervention product will be assessed along with measures related to 'cost-effectiveness'.

A sub-study will be performed in a sub-group (n=30) to investigate if bio-impedance analysis (BIA) correlates with Dual-Energy X-ray absorptiometry (DXA) at single time points, and to see if it is possible to track changes in lean body mass. In addition, the reliability of the bio-impedance analyzer will be evaluated.

Also, the prevalence and classification of sarcopenia will be assessed at baseline, and correlations to nutritional status will be investigated (n=120).


Options:
A: Inclusion Criteria:

* Men and women aged ≥ 70 years old
* Able to speak and understand Danish
* Expected length of stay \> 3 days (evaluated by medical staff at department)
* Ability to stand independently without walking aids
* Admitted to the medical departments of Gentofte or Herlev Hospital or Rigshospitalet-Glostrup

Exclusion Criteria:

* Active cancer
* Renal insufficiency (eGFR \< 30 mL/min/1.73m2)
* Cognitive impairment (not able to comprehend the purpose of the study/give informed consent)
* Terminal disease
* Exclusively receiving enteral or parenteral nutrition
* Milk/lactose allergy or intolerance
* Planning to lose weight/go on a special diet
* Planned transfer to other hospitals/departments
* Pacemaker/other implanted electrical stimulants (due to Bio-Impedance Analysis (BIA) measurements)
* Not being able to lie still in seven minutes (only an exclusion criteria in the sub-study)
* Withdrawal criteria: Death during admission (does not apply to subsequent admissions)
* Withdrawal criteria: Discharge/transfer from the medical department before the intervention has started
B: Inclusion Criteria:

* Patients aged 65 years and older hospitalized for rehabilitation after an acute medical condition
* Expected duration of the rehabilitation ≥ 2 weeks
* Ability to follow instructions to perform a Timed up and Go Test
* Ability to perform exercises
* Willing to participate in 4 sessions of HIIT per week for 2 weeks

Exclusion Criteria:

* Any acute condition with tachycardia, hypotension or fever.
* Abnormal cycle ergometer stress test with
* significant ECG modification
* decrease of more than 20 mmHg of the blood pressure with exercise
* angina
* ST depression at a workload \<6 METs
* Inability to reach an intensity of 15/20 in the Borg's scale of perceived exertion
* Any unresolved acute medical or surgical condition of the following kind:
* acute heart failure
* acute coronary syndrome \< 1 month
* strole \< 1 month
* active pericarditis / myocarditis / endocarditis
* thromboembolic disease with \< 2 weeks of anticoagulation
* acute infection requiring intravenous treatment
* ongoing intravenous perfusion
* surgery \< 2 months
* recent bone fracture
* Previous episode of primary cardiac arrest (ie, cardiac arrest that did not occur in the presence of an acute myocardial infarction or during a cardiac procedure).
* Severe heart failure (NYHA III and IV)
* Severe stenotic or regurgitant valvular disease
* Uncontrolled hypertension at rest (SBP≥160mmHg, DBP≥100mmHg)
* Uncontrolled dysrhythmia
* Non-sustained ventricular tachycardia with exercise
* Implanted defibrillator
* Obstructive cardiomyopathy
* Resting HR \> 100/min
* Severe peripheral artery disease
* Severe COPD (VEMS \< 50%)
* Exercise-induced asthma
* Oxygen dependency
* Muscular-skeletal anomaly that may limit exercise participation
* Delirium
* Inability to follow instructions
* Inability to consent
C: Inclusion Criteria:

* Age: 65 years or older.
* Able to ambulate, with or without personal/ technical assistance.
* Able to communicate.

Exclusion Criteria:

* Expected length of stay \<72 hours
* Patients permanently bedridden prior to admission
* Any factor precluding performance of the physical training program. These factors include, but are not limited to the following:

  * Terminal illness.
  * Unstable cardiovascular disease or other medical condition.
  * Severe dementia.
D: Inclusion Criteria:

* \>=65 years of age
* admitted from own home

Exclusion Criteria:

* Terminal illness
* In treatment for diagnosed cancer
* Assigned to physical rehabilitation in community
* Chronic Obstructive Pulmonary Disease (COPD) patients participating in organized rehabilitation
* Living outside of the municipalities of Copenhagen and Broendby
* Not able to talk and understand danish
* Not able to cooperate on tests/exercises
* Hospitalized \< 24 hours
* A Cumulated Ambulation Score (CAS) of 0 in the sit-to-stand item

Answer: A