1a. Objectives (from AD-416):
LAB NAME: Nutrition, Exercise Physiology, and Sarcopenia 1. Characterize the mechanisms associated with nutritional and contraction-related mediators of anabolic resistance associated with advancing age and/or obesity in animal models and humans. 2. Determine the effects of structured, long term interventions of aerobic walking and resistance physical activity on physical functioning in older adults with chronic kidney disease or limited mobility. 3. Determine the effects of structured, long term interventions of aerobic walking and resistance physical activity on cognitive functioning in older adults with chronic kidney disease or limited mobility.
1b. Approach (from AD-416):
LAB NAME: Nutrition, Exercise Physiology, and Sarcopenia Sarcopenia, the age-associated loss in skeletal muscle mass and function, is a contributing factor to the observed declines in physiological capacity and physical functioning with advancing age. The overall theme of this project will be to conduct basic and clinical studies focused on the identification, evaluation, and understanding of nutritional and physical activity interventions that possess anabolic properties in skeletal muscle and have the potential to prevent or reverse impaired motor and cognitive performance and/or physical dysfunction in older individuals. Our basic research program will focus on understanding the molecular mechanisms associated with age-related anabolic resistance in skeletal muscle. These basic studies will be uniquely synergized with our clinical/translational studies designed to evaluate the potential efficacy of nutritional and exercise interventions in older adults. Our proposed clinical studies will further seek to understand the role of structured physical activity and nutritional supplementation on changes in physical function and disability in older adults with mobility limitations as a consequence of anabolic resistance and/or sarcopenia. In addition, we will also examine the role of structured physical activity on changes in cognition and the role of physical activity on dementia risk. The pairing of clinical studies examining the influence of protein nutrition and physical activity on sarcopenia with basic approaches that identify the molecular landscape and potential targets in skeletal muscle for preventive interventions (nutritional, physical activity) may accelerate our ability to translate these findings to aging people.
3. Progress Report:
This project has made substantial progress on all objectives outlined in our project plan. In the current project year, we have fully met nearly all of our approved milestones. Work on objectives 1. Characterize the mechanisms associated with nutritional and contraction-related mediators of anabolic resistance associated with advancing age and/or obesity in animal models and humans, 2. Determine the effects of structured, long term interventions of aerobic walking and resistance physical activity on physical functioning in older adults with chronic kidney disease or limited mobility, and 3. Determine the effects of structured, long term interventions of aerobic walking and resistance physical activity on cognitive functioning in older adults with chronic kidney disease or limited mobility, is all ongoing. Substantial progress has been made on objective 1 with recent work highlighting the ability to examine aspect of micro-RNA regulation of skeletal muscle growth using muscle cell culture derived from human biopsy samples. For objectives 2 and 3, the proposed clinical trials have been initiated and one of these projects is nearing completion ahead of schedule.
1. Impact of declines in muscle mass and power on fear of falling and quality of life. The age-associated loss of skeletal muscle quantity and function are critical determinants of independent physical functioning in later life. Longitudinal studies investigating how decrements in muscle function impact fear of falling (FoF) and quality of life in older adults are lacking. Tufts University researchers at USDA in Boston, Massachusetts, examined 3-year changes in muscle mass, strength, power, and physical performance among older adults (26 healthy older subjects (age, 74.11 +/- 3.7; Short Physical Performance Battery (SPPB) score >/= 10) and 22 mobility-limited older subjects (age, 77.2 +/- 4.4; SPPB score = 9) and showed that declining muscle function (strength and power) is an independent contributing factor to increased fear of falling and to deteriorations in quality of life. These findings reinforce the importance of preserving muscle health with advancing age to reduce fall risk and improve quality of life.
2. Disseminating a clinically effective physical activity program to preserve mobility to the community. As the population of older adults continues to increase, the dissemination of strategies to maintain independence of older persons is of critical public health importance. Tufts University researchers at USDA in Boston, Massachusetts, assessed the ability to disseminate an evidence-based physical activity program for older adults by evaluating program participation and its impact on mobility, strength and quality of life. Fifty older adults (71.2 ± 8 years aged; BMI: 30.1 ± 7 kg/m2) were studied at program entry and following 8 months of participation. Overall program attendance was high (55.8%)and participants exhibited sustained increases in physical activity participation, meaningful improvements in physical functioning, lower leg strength and quality of life. These findings indicate that dissemination of a clinically efficacious physical activity intervention into a community-based setting can improve mobility, strength and quality of life for older adults. This knowledge may be helpful for the design and implementation of larger-scale physical activity intervention studies designed to preserve mobility in older adults within community-based settings.
5. Significant Activities that Support Special Target Populations:
The Nutrition, Sarcopenia, Physical Activity, and Skeletal Muscle Function in the Elderly project continues to maintain a strong collaboration with two community agencies and have initiated collaboration with a third through its ongoing support of the Fit-4-Life Program. This community-based physical activity and nutrition counseling intervention was first implemented at the Kit Clark Senior Services’ facility, the Madden Senior Center in Dorchester, Massachusetts in 2007. To date, The Fit-4-Life Program in Dorchester has enrolled over 500 multicultural older adults living mainly in the Dorchester, Roxbury, South Boston and Mattapan sections of Greater Boston, many of whom have limited incomes, little education and few resources. In October 2012, The Fit-4-Life Program was extended into the Somerville, Massachusetts community through a new collaboration with the Somerville Council on Aging. To date, approximately 350 older adults have enrolled in The Fit-4-Life Program in Somerville across two sites: the Holland Street Senior Center and the Visiting Nurses Association Senior Living Community on Alewife Brook Parkway in Somerville. Overall, many seniors participating in The Fit-4-Life Program have made substantial health gains through improvements in physical functioning, cardiovascular health, general well-being and quality of life. The program in Somerville is seeking to continue to expand and reach a greater number of older citizens in the community. In July 2013, the Nutrition, Physical Activity, and Sarcopenia in the Elderly project initiated a partnership with the Wang YMCA of Chinatown in Boston to collaborate on a Healthy Habits Program, a community-based physical activity and health education intervention for Chinese-American older adults. Over 100 older adults participated in the Healthy Habits Program, and many subjects demonstrated significant improvements in mobility, cognitive function and health-related quality of life. These collaborations remain ongoing.
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