Synergistic effects of physical and psychological stress upon immunesenescence

Lead Research Organisation: University of Birmingham
Department Name: Immunity and Infection

Abstract

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.
 
Description This grant aimed to understand poor outcomes after hip fracture, namely poor physical recovery and increased risk of infections. We aimed to determine if the physical stress of a hip fracture was made worse of accompanied by depression. The Key findings from our work were that in fact those patients who did not develop depression had good physical recovery and their immune systems were no different from a healthy control. In contrast the patients who developed depression had poor physical recovery and reduced immune function compared tot eh non-depressed patients and healthy controls.
Our data thus make it clear that tackling and preventing depression in hip fracture patients should be a clinical priority if good recovery is to be achieved.
Exploitation Route Our findings indicate that efforts should be placed on preventing or treating depression promptly in hip fracture patients. This could be via a psychosocial intervention or a pharmacological one (we suggest DHEA supplementation). Trials are now needed to test both of these approaches to see if they improve outcomes after hip fracture.
Sectors Communities and Social Services/Policy,Education,Healthcare,Pharmaceuticals and Medical Biotechnology

 
Description The data from this project have been used to help design an RCT to test an intervention to reduce depression and improve physical recovery in hip fracture patients. Our data suggested that a stress hormone imbalance may be causing the onset of depression and increased frailty in hip fracture patients. The RCT will comprise a hormone replacement therapy and the primary outcomes will be reduced depression and improved physical functioning after hip fracture. Improved immunity will be a secondary outcome. We have now received funding from NIHR and UHB charities to carry out a pilot study to determine the dose of the hormone to be used in both hip fracture and major trauma victims. This trial will commence in spring 2019 and be complete late in 2019.
First Year Of Impact 2018
Sector Healthcare
Impact Types Policy & public services

 
Description Move It or Lose It Training Programme
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact The MIOLI Training programme
 
Description Preventing frailty workshops
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
URL https://www.staffordshire.gov.uk/health/PublicHealth/Annual-Public-Health-Report-2014.pdf
 
Description AgeWell annual research days
Amount £15,000 (GBP)
Organisation University of Birmingham 
Department Medawar Centre for Healthy Ageing Research
Sector Academic/University
Country United Kingdom
Start 09/2011 
End 10/2013
 
Description AgeWell annual research days continued
Amount £15,000 (GBP)
Organisation Versus Arthritis 
Department Arthritis Research UK Centre for Musculoskeletal Ageing Research
Sector Academic/University
Country United Kingdom
Start 09/2014 
End 10/2017
 
Description Horizon 2020 Marie Curie Multi-site International Training Network
Amount € 2,873,941 (EUR)
Funding ID [675003] 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 01/2016 
End 12/2020
 
Description NIHR Centre for Surgical Reconstruction and Microbiology
Amount £6,000,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Centre for Surgical Reconstruction and Microbiology
Sector Academic/University
Country United Kingdom
Start 07/2016 
End 06/2019
 
Description 'Put Pep in Your Step' DVD 
Organisation Move it or Lose It
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We produced and released our own DVD, launched on October 1st 2013 on World Older Adults Day, comprising a staged exercise programme based on the PEPPI programme validated by Prof Bill Evans but also employing factors revealed by our motivational psychology team to enhance self determination to lifestyle change. These include the use of music and using demonstrators of the appropriate age group, we thus used members of the Birmingham 1000 Elders as the actors on the DVD
Collaborator Contribution Industrial Partner
Impact The DVD is available to buy. Importantly local Age Concern groups and the Birmingham Later Life forum have both bought the DVD to use in their befriending schemes to reduce isolation and improve health in older adults. We have also developed a training course for physical activity trainers in the use of our DVD and exercise programme and we deliver this as a 2-day VTCT accredited course 3 times a year beginning in March 2014. We have also run 2 full day workshops for older adults on healthy ageing with 200 attendees in total.
Start Year 2013
 
Description Preventing Frailty workshops 
Organisation Sanofi Pasteur MSD
Country United Kingdom 
Sector Private 
PI Contribution The collaboration was to deliver a series of three workshops on Healthy Ageing and preventing frailty, with a focus on service change and delivery, in three different counties (Staffordshire, Hampshire and Shropshire) to be attended by key people involved in public health services for older adults. Prof Lord delivered a lecture on Keeping frailty at bay; and held discussions with attendees about how to prevent frailty in older adults.
Collaborator Contribution The partner organised the workshops inviting key players and also funding the whole event.
Impact The main output has been further networking with health care providers to use our DVD and also send people on the associated training programme. Prof Lord has also been invited to deliver similar workshops to Mid-Staffs Health board and contributed to the 2014/15 annual report by the Director of Public Health for Staffordshire which focused on the health of older adults.
Start Year 2014
 
Description Agewell Conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Over 130 people attended this event that was manned by Centre Researchers and Clinicians. This involved presentations and interactive sessions based around healthy ageing that encouraged this group of older adults to consider how they might alter their lifestyles to ensure they would 'age well'.

Participants came away with ideas on how to improve their diets and lifestyles
Year(s) Of Engagement Activity 2014
 
Description British Science Festival presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Not enough exercise, too much stress: the curse of modern living. Speaker and co-organiser at Interactive display and seminar session at the British Science Festival, Birmingham.
Year(s) Of Engagement Activity 2014
 
Description Depression after hip fracture among older adults. Innov-age Magazine, 5, 12-13. 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Magazine article and interview in Innov-age about depression and hip fracture and ageing research generally to raise public awareness.
Year(s) Of Engagement Activity 2014
URL http://www.edwardhealthcare.org/research/innov-age-magazine/innov-age-musculoskeletal-issue/
 
Description ESRC Feature Story 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Health professionals
Results and Impact Economic and Social Research Council (ESRC). Feature story (online). Healthier Living: Cardiff or Bangladesh? 5 April 2013.

Awareness
Year(s) Of Engagement Activity 2013
URL http://www.esrc.ac.uk/news-and-events/features-casestudies/features/25649/Healthier_living_Cardiff_o...
 
Description Exercising our brains, cells and muscles to fight the ageing process. http://pintofscience.co.uk/event/healthy-ageing/ Speaker and organizer at Pint of Science, Birmingham, May 2015. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Pint of Science public engagement interactive seminar in the pub: Speaker and organizer. Intention to broaden public awareness of the benefits of exercise for different aspects of health.
Year(s) Of Engagement Activity 2015
 
Description Grief leaves the body at risk of infection 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Article in the Daily Telegraph

The Daily Telegraph
Year(s) Of Engagement Activity 2012
URL http://www.telegraph.co.uk/health/healthnews/9164466/Grief-leaves-the-body-at-risk-of-infection.html
 
Description Hip fracture and depression in older adults. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Hip fracture and depression in older adults. Talk at Public engagement conference about balance and falls aimed at older adults, University of Birmingham, June 2016.
Year(s) Of Engagement Activity 2016
URL http://www.birmingham.ac.uk/schools/sport-exercise/news/2016/Control-of-Movement-and-Active-Ageing-O...
 
Description Hip fracture and depression study introductory video 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Participants in your research or patient groups
Results and Impact Video clip introducing the study and its aims. This clip introduces the concept that depression after hip fracture can influence wellbeing in older age and then introduces the New Dynamics of Ageing project on this about which information was also presented at AgeWell a one day conference for older adults and relevant health professionals.

This clip introduces the concept that depression after hip fracture can influence wellbeing in older age and then introduces the New Dynamics of Ageing project on this about which information was also presented at AgeWell a one day conference for older ad
Year(s) Of Engagement Activity 2009
 
Description How stress affects your health. Speaker at Headway, Birmingham - Action on Brain Injury week, 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Patients, carers and/or patient groups
Results and Impact How stress affects your health. Speaker at Headway, Action on Brain Injury week, Birmingham, May 2015. Talk to individuals who have experienced brain injury about stress and its impact.
Year(s) Of Engagement Activity 2015
 
Description Immunity, stress and ageing 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Talk at joint NDA and LLHW Public Engagement event A talk on our NDA research outcomes to a mixed audience of scientists, social scientists, research participants, and associated professionals interested in ageing research.

A talk on our NDA research outcomes to a mixed audience of scientists, social scientists, research participants, and associated professionals interested in ageing research.
Year(s) Of Engagement Activity 2013
 
Description Levels of antibodies in saliva are associated with risk of mortality. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Levels of antibodies in saliva are associated with risk of mortality. Media engagement, e.g., the Times, Daily Mail, Huffington Post, Science Daily etc.
Year(s) Of Engagement Activity 2015
URL http://www.sciencedaily.com/releases/2015/12/151223221330.htm
 
Description Loneliness and isolation, can it affect your immunity? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Loneliness and isolation, can it affect your immunity? Speaker at Dudley Age Alliance - Public engagement for older adults and practitioner, charities and health care providers
Year(s) Of Engagement Activity 2015
 
Description Loneliness and isolation, can it affect your immunity? Speaker at Dudley Age Alliance 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Loneliness and isolation, can it affect your immunity? Speaker at Dudley Age Alliance - Public engagement for older adults. Invited by a member of the Birmingham 1000 elders cohort which was revamped at the original AgeWell meeting funded by this grant.
Year(s) Of Engagement Activity 2015
 
Description New Dynamics of Ageing end of programme dissemination event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The workshop stimulated contacts from several people who are working in the community with older people. In particular there was interest in an exercise DVD we have developed to help frail older adults increase their physical function after hip fracture.

After the workshop I was contacted by an SME in London to help them develop an evidence base for their exercise DVD.
Year(s) Of Engagement Activity 2013
 
Description Newspaper Article - Sunday Telegraph 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Article on Stress and Ageing in the Sunday Telegraph

Public awareness
Year(s) Of Engagement Activity 2013
 
Description Princes Teaching Institute 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact This activity relates to 2 talks given at a series of workshops for secondary school science teachers organised by the Princes Teaching Institute. We have given the 2 talks, covering Human Ageing and The Response to Trauma to 4 workshops around the UK. As a result we have been invited to give these talks to school pupils in the schools the teachers belong to. The original session and the ones in schools have triggered lively discussion of the topics and been very enjoyable as well as raising awareness of the two topic areas.
Year(s) Of Engagement Activity 2014,2015,2016