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
Palmer KT
(2017)
Frailty, prefrailty and employment outcomes in Health and Employment After Fifty (HEAF) Study.
in Occupational and environmental medicine
Parsons CM
(2019)
Novel Approach to Estimate Osteoarthritis Progression: Use of the Reliable Change Index in the Evaluation of Joint Space Loss.
in Arthritis care & research
Parsons CM
(2021)
Determining individual trajectories of joint space loss: improved statistical methods for monitoring knee osteoarthritis disease progression.
in Osteoarthritis and cartilage
Parsons CM
(2020)
Are jumping mechanography assessed muscle force and power, and traditional physical capability measures associated with falls in older adults? Results from the Hertfordshire Cohort Study.
in Journal of musculoskeletal & neuronal interactions
Parsons CM
(2022)
Assessment of Activity Profiles in Older Adults and Lower Limb Bone Parameters: Observations from the Hertfordshire Cohort Study.
in Calcified tissue international
Parsons CM
(2020)
Intergenerational effect of early-life growth on offspring height: Evidence from the Hertfordshire Cohort Study.
in Paediatric and perinatal epidemiology
Pastorino S
(2019)
Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies.
in BJOG : an international journal of obstetrics and gynaecology
Patel A
(2018)
Mild cognitive impairment is associated with poor physical function but not bone structure or density in late adulthood: findings from the Hertfordshire cohort study.
in Archives of osteoporosis
Patel A
(2018)
Longitudinal Change in Peripheral Quantitative Computed Tomography Assessment in Older Adults: The Hertfordshire Cohort Study.
in Calcified tissue international
Patel H
(2022)
A cross-sectional study of the relationship between recreational sporting activity and calcaneal bone density in adolescents and young adults.
in The Physician and sportsmedicine
Patel H
(2020)
The Relationship Between Non-elite Sporting Activity and Calcaneal Bone Density in Adolescents and Young Adults: A Narrative Systematic Review
in Frontiers in Physiology
Patel HP
(2015)
Skeletal muscle morphology in sarcopenia defined using the EWGSOP criteria: findings from the Hertfordshire Sarcopenia Study (HSS).
in BMC geriatrics
Patel HP
(2018)
Muscle Mass, Muscle Morphology and Bone Health Among Community-Dwelling Older Men: Findings from the Hertfordshire Sarcopenia Study (HSS).
in Calcified tissue international
Patel HP
(2014)
Lean mass, muscle strength and gene expression in community dwelling older men: findings from the Hertfordshire Sarcopenia Study (HSS).
in Calcified tissue international
Pennells L
(2019)
Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies.
in European heart journal
Perry TA
(2020)
Occupation and risk of knee osteoarthritis and knee replacement: A longitudinal, multiple-cohort study.
in Seminars in arthritis and rheumatism
Phillips CM
(2019)
Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review.
in Nutrients
Pilgrim A
(2015)
Measuring appetite with the simplified nutritional appetite questionnaire identifies hospitalised older people at risk of worse health outcomes
in The journal of nutrition, health & aging
Pilgrim AL
(2015)
An overview of appetite decline in older people.
in Nursing older people
Pinedo-Villanueva R
(2019)
Health Care Costs Associated With Muscle Weakness: A UK Population-Based Estimate.
in Calcified tissue international
Pinedo-Villanueva R
(2019)
Imminent fracture risk assessments in the UK FLS setting: implications and challenges.
in Archives of osteoporosis
Pinedo-Villanueva R
(2023)
Expected Benefits and Budget Impact From a Microsimulation Model Support the Prioritization and Implementation of Fracture Liaison Services.
in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Pinedo-Villanueva R
(2019)
Health Care Costs Associated With Muscle Weakness: A UK Population-Based Estimate.
in Calcified tissue international
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
Portegijs E
(2020)
Neighborhood Resources Associated With Active Travel in Older Adults-A Cohort Study in Six European Countries.
in Journal of aging and physical activity
Pujadas E
(2022)
Prediction of incident cardiovascular events using machine learning and CMR radiomics
in European Radiology
Pujadas ER
(2022)
Atrial fibrillation prediction by combining ECG markers and CMR radiomics.
in Scientific reports
Pérez-Mojica JE
(2020)
Docosahexaenoic acid and oleic acid induce altered DNA methylation of individual CpG loci in Jurkat T cells.
in Prostaglandins, leukotrienes, and essential fatty acids
Radojcic MR
(2020)
Pain trajectory defines knee osteoarthritis subgroups: a prospective observational study.
in Pain
Raisi-Estabragh Z
(2021)
Cardiac Magnetic Resonance Radiomics Reveal Differential Impact of Sex, Age, and Vascular Risk Factors on Cardiac Structure and Myocardial Tissue
in Frontiers in Cardiovascular Medicine
Raisi-Estabragh Z
(2021)
Poor Bone Quality is Associated With Greater Arterial Stiffness: Insights From the UK Biobank.
in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
Raisi-Estabragh Z
(2021)
Adverse cardiovascular magnetic resonance phenotypes are associated with greater likelihood of incident coronavirus disease 2019: findings from the UK Biobank.
in Aging clinical and experimental research
Raisi-Estabragh Z
(2023)
Lower birth weight is linked to poorer cardiovascular health in middle-aged population-based adults.
in Heart (British Cardiac Society)
Raisi-Estabragh Z
(2022)
Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank.
in Heart (British Cardiac Society)
Raisi-Estabragh Z
(2020)
Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank.
in Journal of public health (Oxford, England)
Raisi-Estabragh Z
(2020)
Renin-Angiotensin-Aldosterone System Blockers Are Not Associated With Coronavirus Disease 2019 (COVID-19) Hospitalization: Study of 1,439 UK Biobank Cases.
in Frontiers in cardiovascular medicine
Raisi-Estabragh Z
(2020)
Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK
in PLOS ONE
Raisi-Estabragh Z
(2023)
Incident cardiovascular events and imaging phenotypes in UK Biobank participants with past cancer.
in Heart (British Cardiac Society)
Raisi-Estabragh Z
(2023)
Incident Clinical and Mortality Associations of Myocardial Native T1 in the UK Biobank.
in JACC. Cardiovascular imaging
Raisi-Estabragh Z
(2020)
Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank.
in Journal of public health (Oxford, England)
Ralston S
(2019)
Diagnosis and Management of Paget's Disease of Bone in Adults: A Clinical Guideline
in Journal of Bone and Mineral Research
Rambukwella R
(2023)
Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study.
in Aging clinical and experimental research
Reginster JY
(2016)
Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia.
in Aging clinical and experimental research
Reginster JY
(2021)
Update on the ESCEO recommendation for the conduct of clinical trials for drugs aiming at the treatment of sarcopenia in older adults.
in Aging clinical and experimental research
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
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 |
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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 |