Sarcopenia, Frailty and Clinical Practice in Older People
Lead Research Organisation:
University of Southampton
Department Name: UNLISTED
Abstract
The mission of the MRC Lifecourse Epidemiology Unit is to provide a centre of excellence which uses epidemiological methods to promote human health by delineating the environmental and occupational causes throughout the lifecourse of: (1) chronic musculoskeletal disorders (osteoporosis, osteoarthritis and sarcopenia); and (2) metabolic disorders (diabetes mellitus, obesity and cardiovascular disease). Through understanding these causes, we aim to develop population-based and high risk preventive strategies against these disorders. This programme will explore the mechanisms which underlie the ageing of human muscle, and lead to physical frailty in later life.
Technical Summary
We will establish an ageing research programme that builds on our progress to date in the fields of sarcopenia and cognition, and capitalises on our expertise in these areas to investigate their links with frailty and wellbeing. Our aim is to carry out high quality interdisciplinary ageing research that informs clinical practice and translates into the improved health of older people. We will focus on mechanisms, lifecourse influences, clinical consequences and interventions. In a group of HCS participants, we will examine the contribution of altered muscle fibre composition, reduction in muscle fibre number and size, and reduced capillary density to the link between small size at birth and sarcopenia. Understanding the cellular mechanisms underlying the association between birthweight and sarcopenia has the potential to inform clinical practice in older people with regard to both prediction and prevention. As part of the HALCyon research programme, we will use data from nine UK cohorts to investigate influences over the lifecourse on cognitive and physical capability and psychological wellbeing in later life. We will also examine the longitudinal relation between sarcopenia and physical frailty and subsequent wellbeing and cognitive function. Study of the inter-relationships between cognition, wellbeing, sarcopenia and frailty across the lifecourse will enable causal associations to be identified and inform the timing of interventions to maximise capability and wellbeing in later life. We will carry out two studies to elucidate the consequences of sarcopenia, frailty and chronic disease for receipt of hospital care. Firstly, by linkage of the existing HCS data to routine Hospital Episode Statistics data, we will investigate the association between sarcopenia, frailty and chronic disease and incidence of hospital admission. Secondly, in patients aged over 80 admitted to the Acute Medical Unit in Southampton, we will examine how these conditions influence length of stay and adverse clinical outcomes. The findings from these studies have the potential to inform both clinical practice and health policy. Finally, we plan to develop two clinical interventions for sarcopenia and frailty. In the first study, of community dwelling older people participating in the Hertfordshire Physical Activity Trial, we will assess the short- and long-term effects of exercise training on sarcopenia, physical performance, frailty and wellbeing. In the second study, of hospitalised older people, we will investigate whether the use of volunteers to provide mealtime assistance can improve dietary intake and clinical outcome through an effect on these conditions. This programme will permit investigation of the mechanisms underlying the developmental origins of sarcopenia, identify inter-relationships between sarcopenia, cognition, frailty and wellbeing across the lifecourse, and determine the effect of these on the receipt of hospital care. The findings will provide evidence for the development of clinical interventions to reduce sarcopenia and frailty and improve the health and quality of life of older people.
Publications
Litwic AE
(2020)
Self-perceived Fracture Risk in the Global Longitudinal Study of Osteoporosis in Women: Its Correlates and Relationship with Bone Microarchitecture.
in Calcified tissue international
Timmermans EJ
(2014)
Self-perceived weather sensitivity and joint pain in older people with osteoarthritis in six European countries: results from the European Project on OSteoArthritis (EPOSA).
in BMC musculoskeletal disorders
Syddall HE
(2015)
Self-reported walking speed: a useful marker of physical performance among community-dwelling older people?
in Journal of the American Medical Directors Association
Ritchie SJ
(2018)
Sex Differences in the Adult Human Brain: Evidence from 5216 UK Biobank Participants.
in Cerebral cortex (New York, N.Y. : 1991)
Remfry E
(2024)
Sex-based differences in risk factors for incident myocardial infarction and stroke in the UK Biobank.
in European heart journal. Quality of care & clinical outcomes
Zengin A
(2021)
Sex-Specific Associations Between Cardiac Workload, Peripheral Vascular Calcification, and Bone Mineral Density: The Gambian Bone and Muscle Aging Study.
in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Zengin A
(2023)
Sex-specific associations between cardiovascular risk factors and physical function: the Gambian Bone and Muscle Ageing Study.
in Journal of cachexia, sarcopenia and muscle
Calvin CM
(2019)
Sex-specific moderation by lifestyle and psychosocial factors on the genetic contributions to adiposity in 112,151 individuals from UK Biobank.
in Scientific reports
Hagenaars SP
(2016)
Shared genetic aetiology between cognitive functions and physical and mental health in UK Biobank (N=112 151) and 24 GWAS consortia.
in Molecular psychiatry
Brown AG
(2013)
Site distribution at the edge of the palaeolithic world: a nutritional niche approach.
in PloS one
Patel HP
(2015)
Skeletal muscle morphology in sarcopenia defined using the EWGSOP criteria: findings from the Hertfordshire Sarcopenia Study (HSS).
in BMC geriatrics
Bateson M
(2019)
Smoking does not accelerate leucocyte telomere attrition: a meta-analysis of 18 longitudinal cohorts.
in Royal Society open science
Hansen L
(2018)
Social inequality and fractures-secular trends in the Danish population: a case-control study.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Gale CR
(2018)
Social isolation and loneliness as risk factors for the progression of frailty: the English Longitudinal Study of Ageing.
in Age and ageing
Roberts HC
(2013)
Southampton Mealtime Assistance Study: design and methods.
in BMC geriatrics
Ishimoto Y
(2018)
Spinal Endoscopy for Delayed-Onset Lumbar Radiculopathy Resulting from Foraminal Stenosis after Osteoporotic Vertebral Fracture: A Case Report of a New Surgical Strategy.
in Case reports in orthopedics
Liu J
(2019)
State of the art in osteoporosis risk assessment and treatment.
in Journal of endocrinological investigation
Davies G
(2018)
Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function.
in Nature communications
Holroyd CR
(2018)
Switching to biosimilar infliximab: real world data in patients with severe inflammatory arthritis.
in Clinical and experimental rheumatology
Chastin SFM
(2018)
Systematic comparative validation of self-report measures of sedentary time against an objective measure of postural sitting (activPAL).
in The international journal of behavioral nutrition and physical activity
Keevil VL
(2015)
Television viewing, walking speed, and grip strength in a prospective cohort study.
in Medicine and science in sports and exercise
Gardner MP
(2013)
Telomere length and physical performance at older ages: an individual participant meta-analysis.
in PloS one
Chotiyarnwong P
(2019)
Temporal changes in access to FRAX® in Thailand between 2010 and 2018.
in Archives of osteoporosis
López Gavilánez E
(2023)
The application of FRAX in Ecuador
in Revista Colombiana de Reumatología
Christoffersen T
(2017)
The association between childhood fractures and adolescence bone outcomes: a population-based study, the Tromsø Study, Fit Futures
in Osteoporosis International
Marsh R
(2019)
The association between crowding within households and behavioural problems in children: Longitudinal data from the Southampton Women's Survey.
in Paediatric and perinatal epidemiology
Hesketh KR
(2019)
The association between maternal-child physical activity levels at the transition to formal schooling: cross-sectional and prospective data from the Southampton Women's Survey.
in The international journal of behavioral nutrition and physical activity
Roberts HC
(2015)
The Association of Grip Strength With Severity and Duration of Parkinson's: A Cross-Sectional Study.
in Neurorehabilitation and neural repair
Buckinx F
(2018)
The Authors reply: "Dual energy X-ray absorptiometry: gold standard for muscle mass?" by Scafoglieri et al.
in Journal of cachexia, sarcopenia and muscle
Buckinx F
(2018)
The authors reply: Letter on: "Pitfalls in the measurement of muscle mass: a need for a reference standard" by Clark et al.
in Journal of cachexia, sarcopenia and muscle
Javaid MK
(2023)
The Capture the Fracture® Partnership: an overview of a global initiative to increase the secondary fracture prevention care for patient benefit.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Allerhand M
(2014)
The dynamic relationship between cognitive function and positive well-being in older people: a prospective study using the English Longitudinal Study of Aging.
in Psychology and aging
Gale CR
(2014)
The dynamic relationship between cognitive function and walking speed: the English Longitudinal Study of Ageing.
in Age (Dordrecht, Netherlands)
Moon RJ
(2023)
The effect of pregnancy vitamin D supplementation on offspring bone mineral density in childhood: a systematic review and meta-analysis.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Moon RJ
(2023)
The effect of pregnancy vitamin D supplementation on offspring bone mineral density in childhood: a systematic review and meta-analysis.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Burn E
(2019)
The effect of rheumatoid arthritis on patient-reported outcomes following knee and hip replacement: evidence from routinely collected data.
in Rheumatology (Oxford, England)
Braithwaite VS
(2019)
The Effect of Vitamin D Supplementation on Hepcidin, Iron Status, and Inflammation in Pregnant Women in the United Kingdom.
in Nutrients
O'Donnell MM
(2020)
The Effects of Different Smoking Patterns in Pregnancy on Perinatal Outcomes in the Southampton Women's Survey.
in International journal of environmental research and public health
McLachlan KJJ
(2018)
The effects of psychological distress and its interaction with socioeconomic position on risk of developing four chronic diseases.
in Journal of psychosomatic research
Clynes MA
(2020)
The epidemiology of osteoporosis.
in British medical bulletin
Dodds RM
(2015)
The Epidemiology of Sarcopenia.
in Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
Gale CR
(2018)
The epigenetic clock and objectively measured sedentary and walking behavior in older adults: the Lothian Birth Cohort 1936.
in Clinical epigenetics
Cesari M
(2013)
The European Union Geriatric Medicine Society (EUGMS) Working Group on <>.
in The Journal of frailty & aging
Roberts HC
(2014)
The feasibility and acceptability of training volunteer mealtime assistants to help older acute hospital inpatients: the Southampton Mealtime Assistance Study.
in Journal of clinical nursing
Zengin A
(2017)
The Gambian Bone and Muscle Ageing Study: Baseline Data from a Prospective Observational African Sub-Saharan Study.
in Frontiers in endocrinology
Pinto D
(2022)
The global approach to rehabilitation following an osteoporotic fragility fracture: A review of the rehabilitation working group of the International Osteoporosis Foundation (IOF) committee of scientific advisors.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Related Projects
Project Reference | Relationship | Related To | Start | End | Award Value |
---|---|---|---|---|---|
MC_UU_12011/1 | 01/05/2013 | 30/06/2021 | £4,112,000 | ||
MC_UU_12011/2 | Transfer | MC_UU_12011/1 | 01/05/2013 | 30/06/2021 | £2,705,000 |
MC_UU_12011/3 | Transfer | MC_UU_12011/2 | 01/05/2013 | 30/06/2021 | £2,101,000 |
MC_UU_12011/4 | Transfer | MC_UU_12011/3 | 01/05/2013 | 30/06/2021 | £4,051,000 |
MC_UU_12011/5 | Transfer | MC_UU_12011/4 | 01/05/2013 | 30/06/2021 | £1,986,000 |
Description | Ageing & Dementia: Improving Routine Care Project Grant |
Amount | £100,000 (GBP) |
Organisation | National Institute for Health Research |
Department | NIHR CLAHRC Wessex |
Sector | Public |
Country | United Kingdom |
Start |
Description | ESRC Project Grant |
Amount | £154,039 (GBP) |
Organisation | Economic and Social Research Council |
Sector | Public |
Country | United Kingdom |
Start |
Description | MRC Population and Systems Medicine Board Project |
Amount | £2,000,000 (GBP) |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start |
Description | Medical Research Council Partnership for Improvement and Innovation in Dietary Assessment Technology (PIIDAT) (Sian Robinson) |
Amount | £688,813 (GBP) |
Funding ID | MR/L02019X/1 |
Organisation | University of Liverpool |
Department | MRC Centre for Drug Safety Science |
Sector | Academic/University |
Country | United Kingdom |
Start |
Description | NIHR HS&DR |
Amount | £451,164 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start |
Description | University of Southampton School of Medicine and National Oceanography Centre Interface Fund |
Amount | £5,000 (GBP) |
Organisation | University of Southampton |
Sector | Academic/University |
Country | United Kingdom |
Start | 06/2009 |
End | 06/2010 |
Description | Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Sian Robinson) |
Organisation | Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group |
Country | Global |
Sector | Academic/University |
PI Contribution | The Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group is a worldwide network of clinical and public health researchers - its work is focused on analysing worldwide trends and health effects of cardiometabolic risk factors. The Collaboration also involves the World Health Organization (WHO), with the results informing global noncommunicable disease (NCD) surveillance. |
Collaborator Contribution | As a collaborator we are contributing data from the Hertfordshire Cohort Study for the ongoing updates of the global estimates |
Impact | No outputs yet - papers expected in due course |
Start Year | 2014 |
Description | MRC Epidemiology Unit University of Cambridge |
Organisation | University of Cambridge |
Department | MRC Epidemiology Unit |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Development of a collaborative research project |
Collaborator Contribution | Development of a collaborative research project |
Impact | PMID 24669786 23737780 22430306 20052455 |
Start Year | 2006 |
Description | University of Dundee |
Organisation | University of Dundee |
Department | Department for Ageing and Health |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Collaborative research project |
Collaborator Contribution | Collaborative research project |
Impact | PMID 24522120 |
Start Year | 2010 |
Description | Anna Pilgrim: Tea Club talk, Southampton (Feb 2014) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Participants in your research and patient groups |
Results and Impact | A talk to residents and helpers at the "Tea Club" of a residential home on the topic of The Southampton Mealtime Assistance Study Greater understanding of the work of the MRC LEU |
Year(s) Of Engagement Activity |
Description | Article in the New Scientist |
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 | An article entitled "Exercise may be the best anti-ageing pill" appeared online and in the print copy of the New Scientist and quoted Avan Aihie Sayer Increased national interest in sarcopenia research |
Year(s) Of Engagement Activity | 2014 |
Description | British Society of Gerontology, Southampton, Sept 2014 (Sian Robinson) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Symposium speaker: Inequalities in health behaviours and lifestyle in older age: what can we do to promote better physical function? Communicating research of the MRC LEU to a wide audience |
Year(s) Of Engagement Activity | 2014 |
Description | Copenhagen Seminar |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Professor Cyrus Cooper lectured at the conference 'The Skeleton from Early Life to Old Age - new paradigms in osteoporosis and bone health'. The lecture from Prof Cooper was extremely well attended by international leaders in the medical profession and was entitled "Global disease burden and Life Course Epidemiology of osteoporosis". |
Year(s) Of Engagement Activity | 2019 |
Description | Cutting Edge Osteoarthritis Meeting, Pembroke College, Oxford, June 2019 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Professor Cyrus Cooper attended and delivered a talk on 'Inspired Careers' at the third Cutting Edge Osteoarthritis Meeting at Pembroke College, Oxford on 24-25 June 2019. |
Year(s) Of Engagement Activity | 2019 |
Description | Herfordshire Open Day in Harpenden on 23rd June 2018 |
Form Of Engagement Activity | Participation in an open day or visit at my research institution |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Study participants or study members |
Results and Impact | Attendance at the Herfordshire Open Day on 23rd June in Harpenden |
Year(s) Of Engagement Activity | 2018 |
Description | Hertfordshire study event, July 2014 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | A group of MRC staff (inc Cyrus Cooper, Avan Aihie Sayer and Sian Robinson) hosted event at the Hertford Theatre for 400 cohort participants and their families Increased understanding of the work of MRC LEU |
Year(s) Of Engagement Activity | 2014 |
Description | Holly Syddall: Lifelab, Oct 2014 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Holly Syddall attended the LifeLab Meet the Scientist training event Increased awareness of the work of the MRC LEU |
Year(s) Of Engagement Activity |
Description | ICFSR, Miami 16th-25th February 2020 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Speaking at the ICFSR 2019 international conference in Miami in February 2019. |
Year(s) Of Engagement Activity | 2019 |
Description | Institute/Faculty of Actuaries Mortality Seminar Series: Frailty Research Workshop |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Dissemination of frailty research of relevance to the insurance and finance industries Increased understanding of the impact of ageing research on different sectors of industry |
Year(s) Of Engagement Activity | 2013 |
Description | Press release for published paper |
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 | Professional Practitioners |
Results and Impact | A press release came out on 12th August 2022 for the paper entitled "Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability - results from the Women's Health Initiative hormone therapy trials." The paper was published in Osteoporosis International. |
Year(s) Of Engagement Activity | 2022 |
Description | Public Engagement Day: Hertfordshire Cohort Study, July 2014 (Sian Robinson) |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Speaker: The diets of men and women in the Hertfordshire Cohort Study - what did we find out? Communicating research of the MRC LEU to a wide audience |
Year(s) Of Engagement Activity | 2014 |
Description | Recent press interaction |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Reuters: David Douglas. Email exchange 24 Sept 2014 Discussion |
Year(s) Of Engagement Activity | 2014 |
Description | Royal Osteoporosis Society Annual Charity Event and Dinner |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Royal Osteoporosis Bone Research Academy dinner and awards in celebration of the progress of the Academy. |
Year(s) Of Engagement Activity | 2019 |
Description | Talk at Southampton Medical and Health Research Conference June 2019 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Dr Beth Curtis gave a talk on bone turnover in pregnancy and how it is linked to vitamin D supplementation and maternal bone health, at the Southampton Medical and Health Research Conference. Pictures and comments about Beth's talk appeared on social media. |
Year(s) Of Engagement Activity | 2019 |
Description | University of Southampton website (Hertfordshire meeting) July 2014 |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Article "Hertfordshire people help make new medical discoveries", reporting the event hosted by MRC LEU at the Hertford Theatre for 400 cohort participants and their families Increased awareness of the work of MRC LEU |
Year(s) Of Engagement Activity | 2014 |
Description | Vertebroplasty Workshop, Feb 2019, Paris |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This group is led by Pr Jean-Denis Laredo and organizes a meeting annually. Prof Cooper was invited to attend the meeting and present as part of a more general round table session where effectiveness of anti-osteoporotic treatments on the prevention of vertebral fractures was discussed. The title of Prof Cooper's presentation was "Epidemiology of osteoporotic vertebral fractures" (with a focus on the evolution over time of incidence and prevalence of vertebral fractures but also on the consequences of vertebral fractures). The participants of this meeting were represented by radiologists but also neurosurgeons, orthopedic surgeons, and few rheumatologists. |
Year(s) Of Engagement Activity | 2019 |