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
Laskou F
(2022)
A pas de deux of osteoporosis and sarcopenia: osteosarcopenia.
in Climacteric : the journal of the International Menopause Society
Laskou F
(2022)
Establishing a Resource to Assess Musculoskeletal Health in Older Adults in the Post-COVID-19 Era: Time to SaLSA?
in Osteology
Laskou F
(2022)
Relationships Between Muscle Parameters and History of Falls and Fractures in the Hertfordshire Cohort Study: Do All Muscle Components Relate Equally to Clinical Outcomes?
in Calcified tissue international
Laskou F
(2022)
A study of diet in older community-dwelling adults in the UK during the COVID-19 pandemic: Findings from the Southampton Longitudinal Study of Ageing (SaLSA).
in Frontiers in nutrition
Laskou F
(2022)
Functional capacity, sarcopenia, and bone health.
in Best practice & research. Clinical rheumatology
Laskou F
(2022)
Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study.
in Journal of cachexia, sarcopenia and muscle
Lallukka T
(2018)
Recurrent back pain during working life and exit from paid employment: a 28-year follow-up of the Whitehall II Study.
in Occupational and environmental medicine
Ladang A
(2023)
Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of
in Calcified tissue international
Kowo-Nyakoko F
(2023)
Evaluation of two methods of bone age assessment in peripubertal children in Zimbabwe.
in Bone
Kline GA
(2023)
General Comorbidity Indicators Contribute to Fracture Risk Independent of FRAX: Registry-Based Cohort Study.
in The Journal of clinical endocrinology and metabolism
Kiely AP
(2015)
Distinct clinical and neuropathological features of G51D SNCA mutation cases compared with SNCA duplication and H50Q mutation.
in Molecular neurodegeneration
Khashayar P
(2019)
FRAX-based intervention and assessment thresholds for osteoporosis in Iran.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Khalid S
(2022)
Comparative risk of acute myocardial infarction for anti-osteoporosis drugs in primary care: a meta-analysis of propensity-matched cohort findings from the UK Clinical Practice Research Database and the Catalan SIDIAP Database.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Keevil VL
(2015)
Television viewing, walking speed, and grip strength in a prospective cohort study.
in Medicine and science in sports and exercise
Keevil VL
(2015)
Cross-sectional associations between different measures of obesity and muscle strength in men and women in a British cohort study.
in The journal of nutrition, health & aging
Keevil V
(2013)
Grip strength in a cohort of older medical inpatients in Malaysia: a pilot study to describe the range, determinants and association with length of hospital stay.
in Archives of gerontology and geriatrics
Kankowski L
(2022)
The Impact of Maternal Obesity on Offspring Cardiovascular Health: A Systematic Literature Review.
in Frontiers in endocrinology
Kanis JA
(2023)
Primary hyperparathyroidism and fracture probability.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2022)
Adjusting conventional FRAX estimates of fracture probability according to the number of prior fractures.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2018)
A brief history of FRAX.
in Archives of osteoporosis
Kanis JA
(2023)
Adjusting conventional FRAX estimates of fracture probability according to the number of prior falls in the preceding year.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2019)
Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women.
in Calcified tissue international
Kanis JA
(2022)
Intervention thresholds and diagnostic thresholds in the management of osteoporosis.
in Aging clinical and experimental research
Kanis JA
(2023)
Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2023)
The need to distinguish intervention thresholds and diagnostic thresholds in the management of osteoporosis.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2020)
Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2018)
Characteristics of recurrent fractures.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2020)
FRAX and ethnicity.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2019)
European guidance for the diagnosis and management of osteoporosis in postmenopausal women.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Kanis JA
(2019)
Executive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women.
in Aging clinical and experimental research
Kanis J
(2018)
Characteristics of recurrent fractures
in Osteoporosis International
Kanis J
(2018)
A brief history of FRAX
in Archives of Osteoporosis
Kanis J
(2019)
Correspondence in response to OSIN-D-18-00831 quantifying imminent risk
in Osteoporosis International
Johansson H
(2017)
FRAX- vs. T-score-based intervention thresholds for osteoporosis.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Javaid MK
(2020)
A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network.
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
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
Jarman M
(2015)
Influences on the diet quality of pre-school children: importance of maternal psychological characteristics.
in Public health nutrition
James P
(2018)
Candidate genes linking maternal nutrient exposure to offspring health via DNA methylation: a review of existing evidence in humans with specific focus on one-carbon metabolism.
in International journal of epidemiology
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
Ishimoto Y
(2018)
A Succession of MRI Scans Supports the Diagnosis of Lumbar Ligamentum Flavum Hematoma: A Case Report and Review of the Literature.
in Case reports in orthopedics
Ishimoto Y
(2020)
Could automated machine-learned MRI grading aid epidemiological studies of lumbar spinal stenosis? Validation within the Wakayama spine study.
in BMC musculoskeletal disorders
Ishimoto Y
(2019)
Factory and construction work is associated with an increased risk of severe lumbar spinal stenosis on MRI: A case control analysis within the wakayama spine study.
in American journal of industrial medicine
Ishimoto Y
(2019)
The Impact of Lumbar Spinal Stenosis, Knee Osteoarthritis, and Loss of Lumbar Lordosis on the Quality of Life: Findings from the Katsuragi Low Back Pain Study.
in Spine surgery and related research
Ireland A
(2018)
Breech presentation is associated with lower bone mass and area: findings from the Southampton Women's Survey.
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 |