# Nutritional (High Protein) Perihabilitation in Older Veterans Undergoing Surgery

> **NIH VA IK2** · DURHAM VA MEDICAL CENTER · 2020 · —

## Abstract

Post-surgical complications are most common in older adults. While a number of factors contribute, one
key determinant is malnourishment. Malnutrition – particularly low protein intake – is seen in up to 86% of
older adults at hospital admission; however, the prevalence of malnutrition in older Veterans is unknown.
Malnutrition and post-surgical complications are linked through two critical observations: 1) malnutrition
dramatically reduces the ability of older adults to overcome postsurgical health stressors, and 2) nutritional
status is likely to deteriorate further during hospitalization and after discharge. Despite convincing evidence
that perioperative nutrition interventions can improve surgical outcomes, such interventions have not been
developed and implemented for our Veterans. Thus, there is a critical need to initiate the required steps to
identify and reduce malnutrition in older Veterans who are anticipating surgery. The overall objectives of the
proposed research are: 1) to validate screening and assessment tools to quickly and accurately identify
perioperative malnutrition in Veterans, and 2) to pilot test a “perihabilitation” intervention of protein
enhanced supplementation to identify its feasibility, fidelity, and acceptability, and 3) to determine the effect
size of physical function in preparation for a larger clinical trial. The Perioperative Optimization of Senior
Health Program (VAPOSH), a new interdisciplinary program at the Durham VAMC, offers a unique
opportunity to develop and pilot test approaches for addressing perioperative malnutrition. Demonstration of
the functional impact of perioperative protein supplementation for malnourished older Veterans will support
this research proposal seeking to identify and treat perioperative malnutrition and improve postoperative
outcomes in older Veterans. The Aims of this project are: 1) to select the appropriate nutrition screening and
assessment tools for VAPOSH Veterans and employ them to characterize malnutrition prevalence and severity
and establish cut-off values associated with malnutrition, 2) to conduct a pilot randomized controlled 6-week
trial of enhanced protein supplementation in a population of malnourished Veterans undergoing elective
surgery; 2.1) use a pilot trial to evaluate the feasibility, fidelity, and acceptability of a perioperative protein-
enhanced intervention compared to an educational control; and 2.2) to determine the effect size for planned
future studies of enhanced protein supplementation in malnourished Veterans, with physical function as the
primary outcome of interest.
 Aim1 encompasses an observational, prospective study that screens and evaluates 75 VAPOSH
patients undergoing elective surgery 1) to report the prevalence of being malnourished or at risk of being
malnourished in VAPOSH patients, 2) determine the criterion validity of the Nutrition Risk Screener-2002
and Patient Generated-Subjective Global Assessment tools, and 3) identify cut-off...

## Key facts

- **NIH application ID:** 9923463
- **Project number:** 5IK2RX002348-04
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Kathryn N Starr
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9923463

## Citation

> US National Institutes of Health, RePORTER application 9923463, Nutritional (High Protein) Perihabilitation in Older Veterans Undergoing Surgery (5IK2RX002348-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9923463. Licensed CC0.

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