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51. Sarcopenia with limited mobility: an international consensus.

Author

Morley, John E, Abbatecola, Angela Marie, Argiles, Josep M, Baracos, Vickie, Bauer, Juergen, Bhasin, Shalender, Cederholm, Tommy, Coats, Andrew J Stewart, Cummings, Steven R, Evans, William J, Fearon, Kenneth, Ferrucci, Luigi, Fielding, Roger A, Guralnik, Jack M, Harris, Tamara B, Inui, Akio, Kalantar-Zadeh, Kamyar, Kirwan, Bridget-Anne, Mantovani, Giovanni, Muscaritoli, Maurizio, Newman, Anne B, Rossi-Fanelli, Filippo, Rosano, Giuseppe MC, Roubenoff, Ronenn, Schambelan, Morris, Sokol, Gerald H, Storer, Thomas W, Vellas, Bruno, von Haehling, Stephan, Yeh, Shing-Shing, Anker, Stefan D, and Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop

Subjects
Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop, Muscle, Skeletal, Humans, Consensus, Internationality, Aged, Middle Aged, Female, Male, Mobility Limitation, Sarcopenia, Stem Cell Research, Aging, Clinical Research, Musculoskeletal, Geriatrics, Clinical Sciences, Nursing, Public Health and Health Services
Abstract

A consensus conference convened by the Society of Sarcopenia, Cachexia and Wasting Disorders has concluded that "Sarcopenia, ie, reduced muscle mass, with limited mobility" should be considered an important clinical entity and that most older persons should be screened for this condition. "Sarcopenia with limited mobility" is defined as a person with muscle loss whose walking speed is equal to or less than 1 m/s or who walks less than 400 m during a 6-minute walk, and who has a lean appendicular mass corrected for height squared of 2 standard deviations or more below the mean of healthy persons between 20 and 30 years of age of the same ethnic group. The limitation in mobility should not clearly be a result of otherwise defined specific diseases of muscle, peripheral vascular disease with intermittent claudication, central and peripheral nervous system disorders, or cachexia. Clinically significant interventions are defined as an increase in the 6-minute walk of at least 50 meters or an increase of walking speed of at least 0.1 m/s.

Published
2011

52. Association of Vascular Health Measures and Physical Function: A Prospective Analysis in the Framingham Heart Study

Author

Sahni, Shivani, primary, Dufour, Alyssa B, additional, Wang, Na, additional, Kiel, Douglas P, additional, Hannan, Marian T, additional, Jacques, Paul F, additional, Benjamin, Emelia J, additional, Vasan, Ramachandran S, additional, Murabito, Joanne M, additional, Newman, Anne B, additional, Fielding, Roger A, additional, Mitchell, Gary F, additional, and Hamburg, Naomi M, additional

Published
2023
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64. Limited physician knowledge of sarcopenia: A survey

Author

Guralnik, Jack M., primary, Cawthon, Peggy M., additional, Bhasin, Shalender, additional, Fielding, Roger, additional, Magaziner, Jay, additional, Cruz‐Jentoft, Alfonso J., additional, Vellas, Bruno, additional, Clarke, Lindsay, additional, Lattimer, Laura, additional, and Evans, William, additional

Published
2023
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72. Correction to: Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review

Author

Bauer, Jürgen M., Cruz-Jentoft, Alfonso J., Fielding, Roger A., Kanis, John A., Reginster, Jean-Yves, Bruyère, Olivier, Cesari, Matteo, Chapurlat, Roland, Al-Daghri, Nasser, Dennison, Elaine, Kaufman, Jean-Marc, Landi, Francesco, Laslop, Andrea, Locquet, Médéa, Maggi, Stefania, McCloskey, Eugene, Perna, Simone, Rizzoli, René, Rolland, Yves, Rondanelli, Mariangela, Szulc, Pawel, Vellas, Bruno, Vlaskovska, Mila, and Cooper, Cyrus

Published
2019
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76. Self‐Reported Function More Informative than Frailty Phenotype in Predicting Adverse Postoperative Course in Older Adults

Author

Kapoor, Alok, Matheos, Theofilos, Walz, Matthias, McDonough, Christine, Maheswaran, Abiramy, Ruppell, Evan, Mohamud, Deeqo, Shaffer, Nicholas, Zhou, Yanhua, Kaur, Shubjeet, Heard, Stephen, Crawford, Sybil, Cabral, Howard, White, Daniel K., Santry, Heena, Jette, Alan, Fielding, Roger, Silliman, Rebecca A., and Gurwitz, Jerry

Published
2017
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77. Novel Potential Targets for Function-Promoting Therapies: Orphan Nuclear Receptors, Anti-inflammatory Drugs, Troponin Activators, Mas Receptor Agonists, and Urolithin A.

Author

Dioh, Waly, Narkar, Vihang, Singh, Anurag, Malik, Fady, Ferrucci, Luigi, Tourette, Cendrine, Mariani, Jean, Maanen, Rob van, and Fielding, Roger A

Subjects
TROPONIN, ORPHANS, ANTI-inflammatory agents, PHYSICAL mobility, SKELETAL muscle
Abstract

In recent years, several new classes of therapies have been investigated with their potential for restoring or improving physical functioning in older adults. These have included Mas receptor agonists, regulators of mitophagy, skeletal muscle troponin activators, anti-inflammatory compounds, and targets of orphan nuclear receptors. The present article summarizes recent developments of the function-promoting effects of these exciting new compounds and shares relevant preclinical and clinical data related to their safety and efficacy. The development of novel compounds in this area is expanding and likely will need the advent of a new treatment paradigm for age-associated mobility loss and disability. [ABSTRACT FROM AUTHOR]

Published
2023
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78. Synergistic Strategies to Accelerate the Development of Function-Promoting Therapies: Lessons From Operation Warp Speed and Oncology Drug Development.

Author

Araujo, Rosaly Correa-de, Evans, William J, Fielding, Roger A, Krishnan, Venkatesh, Carter, Robert H, Appleby, James, Guralnik, Jack, Klickstein, Lloyd B, Marks, Peter, Moore, Alison A, Peschin, Sue, and Bhasin, Shalender

Subjects
COVID-19 vaccines, ANTINEOPLASTIC agents, DRUG development, PHARMACEUTICAL biotechnology industry, VACCINE development
Abstract

Background Functional limitations and physical disabilities associated with aging and chronic disease are major concerns for human societies and expeditious development of function-promoting therapies is a public health priority. Methods Expert panel discussion. Results The remarkable success of Operation Warp Speed for the rapid development of COVID-19 vaccines, COVID-19 therapeutics, and of oncology drug development programs over the past decade have taught us that complex public health problems such as the development of function-promoting therapies will require collaboration among many stakeholders, including academic investigators, the National Institutes of Health, professional societies, patients and patient advocacy organizations, the pharmaceutical and biotechnology industry, and the U.S. Food and Drug Administration. Conclusions There was agreement that the success of well designed, adequately powered clinical trials will require careful definitions of indication/s, study population, and patient-important endpoints that can be reliably measured using validated instruments, commensurate resource allocation, and versatile organizational structures such as those used in Operation Warp Speed. [ABSTRACT FROM AUTHOR]

Published
2023
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79. Exercise and Behavior: Adjuncts to Pro-Myogenic Compounds for Enhancing Mobility in Older Adults.

Author

Storer, Thomas W, Pahor, Marco, Woodhouse, Linda J, Lachman, Margie E, and Fielding, Roger A

Subjects
OLDER people, PHYSICAL mobility, EXERCISE therapy, PHYSICAL activity, COMBINED modality therapy
Abstract

Physical activity and exercise training exert multiple and varied beneficial effects on a wide array of human tissues, making them therapeutic modalities that can prevent and treat age-related decline in physical function. The Molecular Transducers of Physical Activity Consortium is currently working to elucidate the molecular mechanisms underlying how physical activity improves and preserves health. Exercise training, especially when task specific, is an effective intervention for improving skeletal muscle performance and physical function in everyday activities. As seen elsewhere in this supplement, its adjunctive use with pro-myogenic pharmaceuticals may prove to be synergistic in effect. Behavioral strategies aiming to promote exercise participation and sustain adherence are being considered as additional adjuncts to further improve physical function in comprehensive, multicomponent interventions. One application of this combined strategy may be to target multimodal pro-myogenic therapies in prehabilitation to optimize physical preoperative health to enhance functional recovery postsurgery. We summarize here recent progress on biological mechanisms of exercise training, behavioral approaches to exercise participation, and the role task-specific exercise plays in synergy with pharmacologic therapies with a particular focus on older adults. Physical activity and exercise training in multiple settings should serve as the baseline standard of care around which other therapeutic interventions should be considered when the goal is restoring or increasing physical function. [ABSTRACT FROM AUTHOR]

Published
2023
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80. Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial

Author

Sipilä, Sarianna, Tirkkonen, Anna, Hänninen, Tuomo, Laukkanen, Pia, Alen, Markku, Fielding, Roger A., Kivipelto, Miia, Kokko, Katja, Kulmala, Jenni, Rantanen, Taina, Sihvonen, Sanna E., Sillanpää, Elina, Stigsdotter-Neely, Anna, and Törmäkangas, Timo

Published
2018
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81. The AMPK-related kinase SNARK regulates muscle mass and myocyte survival

Author

Lessard, Sarah J., Rivas, Donato A., So, Kawai, Koh, Ho-Jin, Queiroz, Andre Lima, Hirshman, Michael F., Fielding, Roger A., and Goodyear, Laurie J.

Subjects
Phosphotransferases -- Health aspects, Genetic regulation -- Health aspects, Cell differentiation -- Genetic aspects -- Health aspects, Muscle cells -- Genetic aspects, Health care industry
Abstract

The maintenance of skeletal muscle mass is critical for sustaining health; however, the mechanisms responsible for muscle loss with aging and chronic diseases, such as diabetes and obesity, are poorly understood. We found that expression of a member of the AMPK-related kinase family, the SNF1-AMPK-related kinase (SNARK, also known as NUAK2), increased with muscle cell differentiation. SNARK expression increased in skeletal muscles from young mice exposed to metabolic stress and in muscles from healthy older human subjects. The regulation of SNARK expression in muscle with differentiation and physiological stress suggests that SNARK may function in the maintenance of muscle mass. Consistent with this hypothesis, decreased endogenous SNARK expression (using siRNA) in cultured muscle cells resulted in increased apoptosis and decreased cell survival under conditions of metabolic stress. Likewise, muscle-specific transgenic animals expressing a SNARK dominant-negative inactive mutant (SDN) had increased myonuclear apoptosis and activation of apoptotic mediators in muscle. Moreover, animals expressing SDN had severe, age-accelerated muscle atrophy and increased adiposity, consistent with sarcopenic obesity. Reduced SNARK activity, in vivo and in vitro, caused downregulation of the Rho kinase signaling pathway, a key mediator of cell survival. These findings reveal a critical role for SNARK in myocyte survival and the maintenance of muscle mass with age., Introduction Skeletal muscle is essential for maintaining health due to its significant mass, large contribution to whole-body metabolism, and critical role in mobility. Age-induced loss of muscle mass and function, [...]

Published
2016
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83. Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia

Author

Reginster, Jean-Yves, Cooper, Cyrus, Rizzoli, René, Kanis, John A., Appelboom, Geoff, Bautmans, Ivan, Bischoff-Ferrari, Heike A., Boers, Maarten, Brandi, Maria Luisa, Bruyère, Olivier, Cherubini, Antonio, Flamion, Bruno, Fielding, Roger A., Gasparik, Andrea Ildiko, Van Loon, Luc, McCloskey, Eugene, Mitlak, Bruce H., Pilotto, Alberto, Reiter-Niesert, Suzanne, Rolland, Yves, Tsouderos, Yannis, Visser, Marjolein, and Cruz-Jentoft, Alfonso J.

Published
2016
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88. The Clinical Effectiveness of a Physiotherapy Delivered Physical and Psychological Group Intervention for Older Adults With Neurogenic Claudication: The BOOST Randomized Controlled Trial

Author

Williamson, Esther, Boniface, Graham, Marian, Ioana R, Dutton, Susan J, Garrett, Angela, Morris, Alana, Hansen, Zara, Ward, Lesley, Nicolson, Philippa J A, Rogers, David, Barker, Karen L, Fairbank, Jeremy C, Fitch, Judith, French, David P, Comer, Christine, Mallen, Christian D, Lamb, Sarah E, Fielding, Roger, and BOOST Research Group

Subjects
B900, Aging, Geriatrics and Gerontology, R1, C600
Abstract

Background Neurogenic claudication (NC) is a debilitating spinal condition affecting older adults’ mobility and quality of life. Methods A randomized controlled trial of 438 participants evaluated the effectiveness of a physical and psychological group intervention (BOOST program) compared to physiotherapy assessment and tailored advice (best practice advice [BPA]) for older adults with NC. Participants were identified from spinal clinics (community and secondary care) and general practice records and randomized 2:1 to the BOOST program or BPA. The primary outcome was the Oswestry Disability Index (ODI) at 12 months. Data were also collected at 6 months. Other outcomes included ODI walking item, 6-minute walk test (6MWT), and falls. The primary analysis was intention-to-treat. Results The average age of participants was 74.9 years (standard deviation [SD] 6.0) and 57% (246/435) were female. There was no significant difference in ODI scores between treatment groups at 12 months (adjusted mean difference [MD]: −1.4 [95% confidence intervals (CI) −4.03, 1.17]), but, at 6 months, ODI scores favored the BOOST program (adjusted MD: −3.7 [95% CI −6.27, −1.06]). At 12 months, the BOOST program resulted in greater improvements in walking capacity (6MWT MD: 21.7m [95% CI 5.96, 37.38]) and ODI walking item (MD: −0.2 [95% CI −0.45, −0.01]) and reduced falls risk (odds ratio: 0.6 [95% CI 0.40, 0.98]) compared to BPA. No serious adverse events were related to either treatment. Conclusions The BOOST program substantially improved mobility for older adults with NC. Future iterations of the program will consider ways to improve long-term pain-related disability. Clinical Trials Registration Number: ISRCTN12698674

Published
2022

89. Effects of Physical and Cognitive Training on Falls and Concern About Falling in Older Adults : Results From a Randomized Controlled Trial

Author

Turunen, Katri M., Tirkkonen, Anna, Savikangas, Tiina, Hänninen, Tuomo, Alen, Markku, Fielding, Roger A., Kivipelto, Miia, Stigsdotter Neely, Anna, Törmäkangas, Timo, Sipilä, Sarianna, Turunen, Katri M., Tirkkonen, Anna, Savikangas, Tiina, Hänninen, Tuomo, Alen, Markku, Fielding, Roger A., Kivipelto, Miia, Stigsdotter Neely, Anna, Törmäkangas, Timo, and Sipilä, Sarianna

Abstract

Background: The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods: This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results: Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56–1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59–1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes. Conclusion: A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults. Clinical Trial Registration: ISRCTN52388040

Published
2022
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90. Functional improvements to 6 months of physical activity are not related to changes in size or density of multiple lower-extremity muscles in mobility-limited older individuals

Author

Skoglund, Elisabeth, Lundberg, Tommy R, Rullman, Eric, Fielding, Roger A, Kirn, Dylan R, Englund, Davis A, von Berens, Asa, Koochek, Afsaneh, Cederholm, Tommy, Berg, Hans E, Gustafsson, Thomas, Skoglund, Elisabeth, Lundberg, Tommy R, Rullman, Eric, Fielding, Roger A, Kirn, Dylan R, Englund, Davis A, von Berens, Asa, Koochek, Afsaneh, Cederholm, Tommy, Berg, Hans E, and Gustafsson, Thomas

Abstract

Older adults are encouraged to engage in multicomponent physical activity, which includes aerobic and muscle-strengthening activities. The current work is an extension of the Vitality, Independence, and Vigor in the Elderly 2 (VIVE2) study - a 6-month multicenter, randomized, placebo-controlled trial of physical activity and nutritional supplementation in community dwelling 70-year-old seniors. Here, we examined whether the magnitude of changes in muscle size and quality differed between major lower-extremity muscle groups and related these changes to functional outcomes. We also examined whether daily vitamin-D-enriched protein supplementation could augment the response to structured physical activity. Forty-nine men and women (77 ± 5 yrs) performed brisk walking, muscle-strengthening exercises for the lower limbs, and balance training 3 times weekly for 6 months. Participants were randomized to daily intake of a nutritional supplement (20 g whey protein + 800 IU vitamin D), or a placebo. Muscle cross-sectional area (CSA) and radiological attenuation (RA) were assessed in 8 different muscle groups using single-slice CT scans of the hip, thigh, and calf at baseline and after the intervention. Walking speed and performance in the Short Physical Performance Battery (SPPB) were also measured. For both CSA and RA, there were muscle group × time interactions (P < 0.01). Significant increases in CSA were observed in 2 of the 8 muscles studied, namely the knee extensors (1.9%) and the hip adductors (2.8%). For RA, increases were observed in 4 of 8 muscle groups, namely the hip flexors (1.1 HU), hip adductors (0.9 HU), knee extensors (1.2 HU), and ankle dorsiflexors (0.8 HU). No additive effect of nutritional supplementation was observed. While walking speed (13%) and SPPB performance (38%) improved markedly, multivariate analysis showed that these changes were not associated with the changes in muscle CSA and RA after the intervention. We conclude that this type of mult

Published
2022
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93. ENabling Reduction of Low‐grade Inflammation in SEniors Pilot Study: Concept, Rationale, and Design

Author

Manini, Todd M., Anton, Stephen D., Beavers, Daniel P., Cauley, Jane A., Espeland, Mark A., Fielding, Roger A., Kritchevsky, Stephen B., Leeuwenburgh, Christiaan, Lewis, Kristina H., Liu, Christine, McDermott, Mary M., Miller, Michael E., Tracy, Russell P., Walston, Jeremy D., Radziszewska, Barbara, Lu, Jane, Stowe, Cindy, Wu, Samuel, Newman, Anne B., Ambrosius, Walter T., and Pahor, Marco

Published
2017
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99. Validity and Relative Validity of Alternative Methods of Assessing Physical Activity in Epidemiologic Studies: Findings From the Men’s Lifestyle Validation Study

Author

Pernar, Claire H, primary, Chomistek, Andrea K, additional, Barnett, Junaidah B, additional, Ivey, Kerry, additional, Al-Shaar, Laila, additional, Roberts, Susan B, additional, Rood, Jennifer, additional, Fielding, Roger A, additional, Block, Jason, additional, Li, Ruifeng, additional, Willett, Walter C, additional, Parmigiani, Giovanni, additional, Giovannucci, Edward L, additional, Mucci, Lorelei A, additional, and Rimm, Eric B, additional

Published
2022
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