Physiological resilience: mechanisms and consequences

Lead Research Organisation: University College London

Abstract

Resilience, the ability to ‘bounce back’ from a challenge, gets worse with age. For example, older people are less likely to make a full recovery to their pre-illness state from a fall, infection or surgery. This is also true for the response to daily life challenges; for example, older people lose the ability to prevent the fall in blood pressure on standing, and their blood pressure subsequently takes longer to return to normal, than younger people. Similarly, levels of circulating glucose (a simple sugar) in response to a meal takes longer to return to normal in older than younger people. We suggest that loss of resilience is an early marker of poor outcomes, specifically progressive loss of function, increased risk of disease, frailty and death.
We will measure responses to controlled stressors in the clinic (e.g. standing up, physical activity, thinking). This will allow us to determine if a person shows early signs that they will be at more risk of disease and disability in the future. Potentially, we could use measures of resilience to identify people at high risk and may find new ways to intervene to improve their resilience which would lead to better outcomes.

Technical Summary

Aim
We will use dynamic phenotyping to investigate mechanisms underlying impaired physiological resilience with ageing, and quantify its association with functional change and clinical events.
Importance of research
Resilience – the ability to resist or recover from stressors – declines with age, and determines functional status, loss of independence and mortality. While resilience is multifaceted, underlying pathways of impaired resilience are likely to be common across systems, but are poorly understood.
Objectives
Quantify the impact of controlled dynamic stressors on resilience, and determine the extent to which responses to individual stressors are correlated.
Understand the life course environmental exposures, and midlife molecular and physiological determinants of resilience in NSHD.
Explore the consequences of the spectrum of resilience in terms of hospital admission and events
Methodology
Physiological responses to everyday dynamic stressors delivered in an experimental clinic setting, such as mobility, cognitive tasks, orthostatic challenge and food ingestion, will be used to quantify resilience across multiple systems (cardiovascular, metabolic, skeletal muscle, neurological). Participants from NSHD (with rich data on determinants of resilience) will be studied.
Potential translational impact
Identification of predictive resilience measures and underlying pathways would highlight novel biomarkers to categorise older people at high risk of adverse outcomes, and novel targets for intervention.

Publications

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Bhuva AN (2020) Training for a First-Time Marathon Reverses Age-Related Aortic Stiffening. in Journal of the American College of Cardiology

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Chattopadhyay K (2019) Development of a Yoga-Based Cardiac Rehabilitation (Yoga-CaRe) Programme for Secondary Prevention of Myocardial Infarction. in Evidence-based complementary and alternative medicine : eCAM

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Chaturvedi N (2020) Prescribing by Ethnicity: (Im)precision Medicine? in Diabetes care

 
Description Its all academic 2019 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact LHA took part in the UCL Its all academic festival. LHA had their Game of Life activity which was an interactive game where participants learnt about our longitudinal research into healthy ageing.
Year(s) Of Engagement Activity 2019
 
Description Keir Starmer MP Research visit 
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 Local MP, Sir Keir Starmer was invited to the MRC Festival of Medical Research but he was unable to attend. However, he offered to visit the units, who were taking part in the Festival. We and the MRC LMBC took up the opportunity to meet Keir. He met with staff, who explained about the cohort studies we have at the Unit - MRC NSHD, SABRE, LINKAGE and Insight 46 (a substudy of the MRC NSHD).
Year(s) Of Engagement Activity 2019
 
Description MRC Festival June 2019 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact LHA hosted a Science Fair at UCL with the MRC Laboratory for Medical Cell Biology and the MRC Prion. This was a free family fun day for all ages and included hands-on activities, interactive demonstrations, games and exhibitions. LHA had their Game of Life activity which was an interactive game where participants learnt about our longitudinal research into healthy ageing.
Year(s) Of Engagement Activity 2019
 
Description Non communicable diseaes in South Asia Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact NCD in South Asia Workshop 23rd to 24th Jan 2020. Led by Academy of Medical Sciences. Steering committee member, chair and facilitator. Bringing regional experts in NCDs together to discuss research state, gaps, and initiatives. Following the workshop, a written report is being produced and will be disseminated to stakeholders within the region and the UK highlighting the identified next steps to help tackle NCDs South Asia.
Year(s) Of Engagement Activity 2020
 
Description Science Museum Lates 2019 
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 LHA took their Life Course Golf Course activity to the Science Museum Lates. Participants were taken round the miniature golf course by our researchers (the caddy) and learnt about our longitudinal research into healthy ageing
Year(s) Of Engagement Activity 2019