Centre for Musculoskeletal Ageing Research

Ageing is a complex process that results in the reduced functioning of most of the body's organ systems, with the musculoskeletal system (muscle, bone, tendon and cartilage) significantly affected. The musculoskeletal system is compromised not only by loss of muscle, bone and cartilage with age, but also by the decline in function of the nervous system which results in reduced control of movement and balance. Ageing is also often accompanied by weight gain which puts further strain on joints and contributes to erosion of cartilage and bone, increasing the chances of developing Osteoarthritis (OA). Importantly both ageing and obesity decrease physical activity levels and increase the level of inflammation in the body and alter hormone balance, all of which affect the ability of the body to maintain the musculoskeletal system. Therefore increased physical activity and interventions that are able to reduce inflammation and correct age and obesity related hormone changes, offer a way forward for delaying age-related changes in the musculoskeletal system. Objectives: The objective is to set up a Centre of Excellence in Musculoskeletal Ageing Research by integrating and expanding the complementary research and postgraduate training activity of the two leading Midlands based Universities, Birmingham and Nottingham, together with their associated NHS hospital trusts. The Centre will also establish a unique technical facility for measuring human muscle, tendon and bone metabolism that will provide a valuable resource for the UK research community. The Centre's over-arching research aim is to understand how ageing results in loss of musculoskeletal function and to use this knowledge to intervene and minimise age-related musculoskeletal decline and disease. The major focus of these interventions will be exercise and diet. Clinical benefits: The potential clinical benefits of the research carried out by the Centre are significant as age-related loss of musculoskeletal function has major clinical consequences, including increased risk of falls and fracture (hip and wrist), OA and pain. 1 in 3 older adults fall each year and for 76,000 patients this results in hip fracture. Hip fracture is associated with increased morbidity, loss of independence and the 1 year mortality figure for hip fracture is 22%. There are 6 million people with OA in the UK1, a painful condition which reduces the ability to work and has a significant impact upon quality of life. OA is exacerbated by obesity and there are currently no treatments other than pain remediation. Research questions: 1. What are the key factors driving ageing of the component tissues of the musculoskeletal system, both individually and as an integrated system? This will include the role of genetics and lifestyle; the role of inflammation, physical activity and changes in tissue steroid hormones; age-related loss of neuromuscular function and its contribution to reduced coordination, balance and reduced ability to perform complex motor tasks such as driving. 2. Assessment of interventions to improve musculoskeletal function in old age. It is well established that physical activity reduces the loss of muscle and bone mass with age. In young subjects dietary supplements can increase muscle mass, improve metabolism and reduce inflammation, but efficacy in older adults is largely unknown. The Centre will determine optimal exercise and nutritional supplementation regimes for musculoskeletal maintenance in older adults, both healthy and frail. Interventions will also include pharmacological approaches aimed at reducing inflammation and adjusting hormone balance in favour of musculoskeletal maintenance. 3. Identifying psychological and environmental (practical) barriers to increased physical activity or weight loss in older adults will be a key question addressed by the Centre, with the aim of developing interventions that will be practical and attractive to older adults.