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
Lawrence W
(2020)
How can we best use opportunities provided by routine maternity care to engage women in improving their diets and health?
in Maternal & child nutrition
Thame M
(2012)
Fetal growth and birth size is associated with maternal anthropometry and body composition
in Maternal & Child Nutrition
Crozier SR
(2017)
Nausea and vomiting in early pregnancy: Effects on food intake and diet quality.
in Maternal & child nutrition
Zaballa E
(2023)
Function and employment after total hip replacement in older adults: A narrative review.
in Maturitas
Fuggle NR
(2022)
A review of epigenetics and its association with ageing of muscle and bone.
in Maturitas
Dennison EM
(2022)
Osteoarthritis: The importance of hormonal status in midlife women.
in Maturitas
Veronese N
(2018)
Pain is not associated with cognitive decline in older adults: A four-year longitudinal study.
in Maturitas
Abrahamsen B
(2019)
Vitamin D supplementation for musculoskeletal health outcomes in adults - The end of the beginning?
in Maturitas
Woolford S
(2021)
Frailty, multimorbidity and polypharmacy
in Medicine
Keevil VL
(2015)
Television viewing, walking speed, and grip strength in a prospective cohort study.
in Medicine and science in sports and exercise
Meissner LE
(2020)
DYRK1A pathogenic variants in two patients with syndromic intellectual disability and a review of the literature.
in Molecular genetics & genomic medicine
Kiely AP
(2015)
Distinct clinical and neuropathological features of G51D SNCA mutation cases compared with SNCA duplication and H50Q mutation.
in Molecular neurodegeneration
Gale CR
(2013)
Is bipolar disorder more common in highly intelligent people? A cohort study of a million men.
in Molecular psychiatry
Luciano M
(2019)
The influence of X chromosome variants on trait neuroticism
in Molecular Psychiatry
Smith DJ
(2016)
Genome-wide analysis of over 106 000 individuals identifies 9 neuroticism-associated loci.
in Molecular psychiatry
Deary V
(2018)
Genetic contributions to self-reported tiredness.
in Molecular psychiatry
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
Hill WD
(2020)
Genetic contributions to two special factors of neuroticism are associated with affluence, higher intelligence, better health, and longer life.
in Molecular psychiatry
Hagenaars SP
(2018)
Genetic contributions to Trail Making Test performance in UK Biobank.
in Molecular psychiatry
Deary V
(2018)
Genetic contributions to self-reported tiredness.
in Molecular psychiatry
Davies G
(2016)
Genome-wide association study of cognitive functions and educational attainment in UK Biobank (N=112 151).
in Molecular psychiatry
Hill WD
(2019)
A combined analysis of genetically correlated traits identifies 187 loci and a role for neurogenesis and myelination in intelligence.
in Molecular psychiatry
NCD Risk Factor Collaboration (NCD-RisC)
(2020)
Repositioning of the global epicentre of non-optimal cholesterol.
in Nature
NCD Risk Factor Collaboration (NCD-RisC)
(2023)
Diminishing benefits of urban living for children and adolescents' growth and development.
in Nature
Davies G
(2018)
Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function.
in Nature communications
Migliavacca E
(2019)
Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities.
in Nature communications
Cox SR
(2016)
Ageing and brain white matter structure in 3,513 UK Biobank participants.
in Nature communications
Luciano M
(2019)
Author Correction: Association analysis in over 329,000 individuals identifies 116 independent variants influencing neuroticism.
in Nature genetics
Luciano M
(2018)
Association analysis in over 329,000 individuals identifies 116 independent variants influencing neuroticism.
in Nature genetics
Morris JA
(2019)
Author Correction: An atlas of genetic influences on osteoporosis in humans and mice.
in Nature genetics
Morris JA
(2019)
An atlas of genetic influences on osteoporosis in humans and mice.
in Nature genetics
Fuggle NR
(2019)
Fracture prediction, imaging and screening in osteoporosis.
in Nature reviews. Endocrinology
Trombetti A
(2022)
Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia.
in Nature reviews. Endocrinology
Dennison EM
(2017)
Epidemiology of sarcopenia and insight into possible therapeutic targets.
in Nature reviews. Rheumatology
Arden NK
(2021)
Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines.
in Nature reviews. Rheumatology
Roberts HC
(2015)
The Association of Grip Strength With Severity and Duration of Parkinson's: A Cross-Sectional Study.
in Neurorehabilitation and neural repair
Pilgrim AL
(2015)
An overview of appetite decline in older people.
in Nursing older people
Bloom I
(2018)
Diet Quality and Sarcopenia in Older Adults: A Systematic Review.
in Nutrients
Cox NJ
(2019)
Assessment and Treatment of the Anorexia of Aging: A Systematic Review.
in Nutrients
Bloom I
(2018)
Diet Quality and Sarcopenia in Older Adults: A Systematic Review.
in Nutrients
Braithwaite VS
(2019)
The Effect of Vitamin D Supplementation on Hepcidin, Iron Status, and Inflammation in Pregnant Women in the United Kingdom.
in Nutrients
Phillips CM
(2019)
Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review.
in Nutrients
Robinson S
(2017)
Preventing childhood obesity: Early-life messages from epidemiology
in Nutrition Bulletin
Curtis E
(2018)
Early-life dietary and epigenetic influences on childhood musculoskeletal health: Update on the UK component of the ALPHABET project
in Nutrition Bulletin
Okubo H
(2014)
Dietary total antioxidant capacity is related to glucose tolerance in older people: the Hertfordshire Cohort Study.
in Nutrition, metabolism, and cardiovascular diseases : NMCD
Shaw S
(2023)
Influences of the community and consumer nutrition environment on the food purchases and dietary behaviors of adolescents: A systematic review.
in Obesity reviews : an official journal of the International Association for the Study of Obesity
Walker-Bone K
(2016)
Heavy manual work throughout the working lifetime and muscle strength among men at retirement age.
in Occupational and environmental medicine
Zaballa E
(2022)
Feasibility and sustainability of working in different types of jobs after total hip arthroplasty: analysis of longitudinal data from two cohorts.
in Occupational and environmental medicine
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 |