Life course determinants of physical capability and musculoskeletal ageing

Physical capability refers to an individual’s capacity to undertake the physical tasks of daily living. Maintaining physical capability and musculoskeletal function as we grow older are important aspects of healthy ageing, enabling people to live independently for longer and with a higher quality of life. Simple tests of physical capability, such as hand grip strength, balancing on one leg, and time taken to rise from a chair several times or to walk a specified distance are summary measures of individual biological ageing. We have shown that better performance scores are related not only to factors in adult life such as physical activity, health status and social and economic circumstances but also to early life experiences such as early growth patterns and developmental milestones. Within a research programme called ‘HALCyon’ (Healthy Ageing Across the Life Course), we are investigating whether we find similar patterns of association across other UK cohort studies.
In the next five years, we shall examine the change in physical capability and progression to disability and frailty between midlife and old age, how these changes are related to the health of bones, muscles and joints, and how all these aspects of musculoskeletal ageing are linked to experiences and exposures from across the whole of life.

Maintaining physical capability (the capacity to undertake the physical activities of daily living) and musculoskeletal function for the maximal period of time as we grow older are important aspects of healthy ageing, enabling people to be active and independent for longer. Low levels or accelerated loss of capability or musculoskeletal function pose threats to independence and quality of life, are major causes of frailty, disability and death, and impact greatly on health care spending. The ultimate purpose of this programme is to provide evidence to inform the likely timing, intensity and type of future interventions to promote healthy ageing or delay functional decline.
This programme takes a life course approach, investigating biological and social factors from early life that influence later life physical capability and musculoskeletal ageing in population cohorts, in particular in the MRC National Survey of Health and Development (NSHD), a birth cohort study with information on health and life circumstances from 0-65 years. Studies in NSHD and other cohorts have provided evidence that childhood socioeconomic conditions, physical growth and maturation, and motor and cognitive development affect objective measures of midlife capability, such as grip strength, standing balance and chair rise performance, in addition to the cumulative effects of adult health behaviours and socioeconomic conditions.
In the next five years, this programme will capture the change in physical capability and progression to disability and frailty during the transition from midlife to old age in NSHD; and will investigate the lifetime factors (from societal to underlying biology) that drive these changes, and their consequences, for everyday life. Of particular interest for improving human health are the factors that promote the maintenance of maximal functioning, or modify the consequences of functional decline for everyday activities and social integration.
Using new data recently collected or planned, this programme also aims to understand better how factors across life affect bone, muscle and joints in later life and their clinical correlates, osteoporosis and fracture risk, sarcopenia and osteoarthritis. With specialist collaborators we also aim to elucidate underlying biological mechanisms, capitalising on new genomic, epigenomic and metabolomic data in NSHD.
This programme addresses the MRC strategic research priority for 2009-14 to improve the chances of living a long and healthy life by driving forward interdisciplinary research addressing health and wellbeing from childhood to older age.